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Organization
MLT WEIGHT LOSS LLC
Active
Organization
MLT WEIGHT LOSS LLC
Active
Other names
Mary Thompson Sole MBR
Organization subpart
No
Provider details
NPI number
Authorized official
MARY L THOMPSON MD (OWNER)
(706) 922-0440
Entity
Organization
Contact information
Practice address
3830 WASHINGTON RD, SUITE 17, MARTINEZ, GA 30907-5064
(706) 922-0440
(706) 922-0441
Mailing address
3830 WASHINGTON RD, SUITE 17, MARTINEZ, GA 30907-5064
(706) 922-0440
(706) 922-0441
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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