Provider Demographics
NPI:1023446945
Name:THOMPSON, KEITH B I (CMT)
Entity type:Individual
Prefix:MR
First Name:KEITH
Middle Name:B
Last Name:THOMPSON
Suffix:I
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206A 7TH ST
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-1118
Mailing Address - Country:US
Mailing Address - Phone:907-209-6533
Mailing Address - Fax:
Practice Address - Street 1:206A 7TH ST
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-1118
Practice Address - Country:US
Practice Address - Phone:907-209-6533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist
No172M00000XOther Service ProvidersMechanotherapist