Individual
LEO THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3083 28TH ST SE, GRAND RAPIDS, MI 49512-1667
(616) 949-8974
(616) 949-7326
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004570
MI
Other
Enumeration date
07/05/2010
Last updated
04/09/2021
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