Thompson, Stacie Lonnette

Thompson, Stacie Lonnette is an individual health care provider with primary practice located at 36 Professional Plz , Rexburg ID 83440-2049. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Thompson, Stacie Lonnette can be contacted via phone (208) 359-9570.

Contact Information

Primary practice address
36 Professional Plz Rexburg ID 83440-2049
Phone: (208) 359-9570
Fax: (208) 359-9580
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT 1630 Idaho

Profile Details

NPI number 1881805521
LBN Legal business name Thompson, Stacie Lonnette
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2007
Last updated Oct 11th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881805521 NPPES
Idaho MEDICAID 8079668

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