| Doctor Name: | MRS. MARY E THOMSEN |
| NPI Number: | 1154480804 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CERTIFIED FITTER FOR |
| License Number: | |
| Business Practice Address: | 173 Cherry Oak Trail Petal, MS - 39465 |
| Business Phone Number: | 6015430268 |
| Business Fax Number: | |
| Mailing Address: | 173 Cherry Oak Trail, PETAL |
| State: | MS |
| Postal Code: | 39465 |
| Phone Number: | 6015430268 |
| Fax Number: | |
| NPI Enumeration Date: | 12/08/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225000000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Orthotic Fitter |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the management of fitting prefabricated orthoses. |