Individual
TONY L THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11414 W PARK PL STE 202, MILWAUKEE, WI 53224-3500
(414) 716-6219
Mailing address
11414 W PARK PL STE 202, MILWAUKEE, WI 53224-3500
(414) 716-6219
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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