Kelly Thompson

NPI #1093911497 in Milwaukee, Wisconsin

Provider Information

NPI Number: 1093911497
Entity Type: Individual
Name: Kelly Thompson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician
Enumeration Date: Jun 22, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 4929 W FOND DU LAC AVE
City: Milwaukee
State: Wisconsin
ZIP Code: 53216-2324
Phone: (414) 871-6122

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician	374700000X	Primary

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