Individual
DEVANTE QUAREED THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
8944 METROPOLITAN AVE # 89-44, REGO PARK, NY 11374-5331
(718) 459-3689
Mailing address
550 CAULDWELL AVE APT 5B, BRONX, NY 10455-2932
(347) 563-2750
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
031572
NY
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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