Provider Demographics
NPI:1801149182
Name:THOMPSON, LYNN MICHELE
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:MICHELE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9401 APPLE BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-5180
Mailing Address - Country:US
Mailing Address - Phone:804-550-3141
Mailing Address - Fax:
Practice Address - Street 1:9401 APPLE BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-5180
Practice Address - Country:US
Practice Address - Phone:804-550-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004913225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist