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Individual

GERALD THOMPSON CHURCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD CCC-A

Contact information

Practice address
1101 HEALTH PROFESSIONS BUILDING, MT PLEASANT, MI 48859-0001
(989) 774-7301
(989) 774-1891
Mailing address
1101 HEALTH PROFESSIONS BUILDING, MT PLEASANT, MI 48859-0001
(989) 774-7301
(989) 774-1891

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
GC000087
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GC000087
STATE LICENSE NUMBER
MI
01
GC681734
BCBS
MI
Enumeration date
09/28/2006
Last updated
07/09/2007
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