Provider Demographics
NPI:1134246994
Name:THOMPSON, AMY P (PT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:P
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:L
Other - Last Name:PACER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1039 FERN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-3909
Mailing Address - Country:US
Mailing Address - Phone:716-510-6874
Mailing Address - Fax:
Practice Address - Street 1:8128 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-7865
Practice Address - Country:US
Practice Address - Phone:225-791-8666
Practice Address - Fax:225-791-2891
Is Sole Proprietor?:No
Enumeration Date:2007-03-24
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07134R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist