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Individual

LARRY S THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS CHW

Contact information

Practice address
5832 PETRIFIED TREE LN, NORTH LAS VEGAS, NV 89081-6864
(850) 255-1612
Mailing address
5832 PETRIFIED TREE LN, NORTH LAS VEGAS, NV 89081-6864
(850) 255-1612

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
NV

Other

Enumeration date
08/26/2019
Last updated
08/26/2019
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