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Individual

DAVID L THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
59 WEST ST, JACKSON, OH 45640-1566
(740) 395-7001
Mailing address
59 WEST ST, JACKSON, OH 45640-1566
(740) 395-7001

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
4064962
OH
311ZA0620X
Adult Care Home Facility

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4064962
OH
Enumeration date
09/14/2020
Last updated
09/14/2020
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