Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice |
| NPI # | 1205214681 |
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| LBN Legal business name | LAURA THOMAS | ||||
| Authorized official | LAURA THOMAS - (WHNP) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 05/18/2015 | ||||
| Last updated | 05/18/2015 - About 11 years ago | ||||
| Identifiers |
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