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Organization

THEO PEDIATRIC HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTOPHER LOREN THOMPSON MD (OWNER)
(612) 840-4156
Entity
Organization

Contact information

Practice address
1219 1/2 TURNER ST, LANSING, MI 48906-4341
(612) 840-4156
(888) 859-9497
Mailing address
PO BOX 43, MASON, MI 48854-0043
(517) 604-6177
(517) 604-6184

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301103705
MI

Other

Enumeration date
10/11/2017
Last updated
10/11/2017
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