Individual
RICHARD THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 E I 35 FRONTAGE RD, EDMOND, OK 73034-7327
(405) 513-7459
Mailing address
1100 E I 35 FRONTAGE RD, EDMOND, OK 73034-7327
Taxonomy
Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary
108282
OK
Other
Enumeration date
11/04/2011
Last updated
11/04/2011
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