Provider Demographics
NPI:1255110359
Name:THOMPSON, JOY ANN (LMT, CLT)
Entity type:Individual
Prefix:MS
First Name:JOY
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LMT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 CHESAPEAKE AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23661-3450
Mailing Address - Country:US
Mailing Address - Phone:757-679-8349
Mailing Address - Fax:
Practice Address - Street 1:11010 WARWICK BLVD STE 2-B
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-3222
Practice Address - Country:US
Practice Address - Phone:757-806-6808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019007495225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist