Individual
MIRANDA LEANNA THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
17931 HIGHWAY 67 APT 101, STATESBORO, GA 30458-2301
(229) 449-2868
Mailing address
17931 HIGHWAY 67 APT 101, STATESBORO, GA 30458-2301
(229) 449-2868
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/16/2024
Last updated
09/16/2024
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