Individual
ALEC THOMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5570 WILSON AVE, SUIE A, GRANDVILLE, MI 49418
(616) 855-1495
Mailing address
PO BOX 30516, DEPT 5300, LANSING, MI 48909
(616) 608-9979
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501302269
STATE LICENSE
MI
Enumeration date
10/03/2022
Last updated
10/03/2022
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