Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC003422L | PA |
NPI | 1003808577 |
---|---|
Provider Name | Dr. Cherie Lee Thomas |
First Address | Avis, PA 17721-0276 |
Second Address | Lock Haven, PA 17745-8547 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 12/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0010848830001 | (05) | PA |
808657 | FIRST PRIORITY HEALTH (01) | PA |
T30022 | (02) | PA |