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Individual

ADRIAN THOMPSON SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
23206 GAY STREET, EUCLID, OH 44123
(216) 347-2883
(216) 731-0927
Mailing address
23206 GAY STREET, EUCLID, OH 44123
(216) 347-2883
(216) 731-0927

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
80-0579796
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3120732
OH
Enumeration date
10/02/2014
Last updated
10/02/2014
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