Individual
KEN EDWARD THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRPS
Contact information
Practice address
555 STOCKTON ST, JACKSONVILLE, FL 32204-2534
(904) 387-4661
Mailing address
555 STOCKTON ST, JACKSONVILLE, FL 32204-2534
(904) 387-4661
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CRPS0101883
FL
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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