Individual
DEMON RANDOLPH THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPED
Contact information
Practice address
803 E 68TH ST, SAVANNAH, GA 31405-4709
(912) 355-4557
(912) 355-3186
Mailing address
803 E 68TH ST, SAVANNAH, GA 31405-4709
(912) 355-4557
(912) 355-3186
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
CPED3471
GA
Other
Enumeration date
01/09/2013
Last updated
06/13/2014
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