Provider Demographics
NPI:1932756939
Name:THOMPSON, SHARON ROSE (PT, DPT, ATC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ROSE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 E OAKLAND ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-5946
Mailing Address - Country:US
Mailing Address - Phone:402-541-2242
Mailing Address - Fax:
Practice Address - Street 1:255 TEXAS ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7319
Practice Address - Country:US
Practice Address - Phone:402-541-2242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0836352083S0010X
SD2200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine