Individual
MRS. LAURA LEE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4554 W 48TH ST, FREMONT, MI 49412-8721
(231) 924-9295
Mailing address
6151 104TH ST, HOWARD CITY, MI 49329-9611
(231) 937-5722
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007038
MI
Other
Enumeration date
01/20/2012
Last updated
01/20/2012
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