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Individual

RYAN BRADFORD THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
7733 EAST JEFFERSON, DETROIT, MI 48213
(313) 499-4900
Mailing address
17197 N. LAUREL PARK DRIVE, SUITE 161, LIVONIA, MI 48152
(734) 338-8300
(734) 338-8301

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601005559
MI

Other

Enumeration date
09/23/2009
Last updated
09/23/2009
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