Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1943-879AT | LA |
NPI | 1003589466 |
---|---|
Provider Name | Dr. Catherine Thomas |
First Address | Amite, LA 70422-2420 |
Second Address | Amite, LA 70422-2420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2021 |
Last Update Date | 30/07/2021 |