Individual
TREVA THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
712 W. JASMINE DR., LAKE PARK, FL 33403
(561) 951-1770
Mailing address
712 W JASMINE DR, LAKE PARK, FL 33403-2104
(561) 951-1770
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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