Individual
ALPHEUS THOMPSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2146 S RIVERSIDE DR STE 5, EDGEWATER, FL 32141-4257
(386) 689-7578
Mailing address
2146 S RIVERSIDE DR STE 5, EDGEWATER, FL 32141-4257
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
05/22/2020
Last updated
05/22/2020
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