Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | 1092 | OK |
NPI | 1497837017 |
---|---|
Provider Name | Dr. Lee A Thrash |
First Address | Edmond, OK 73013-3745 |
Second Address | Edmond, OK 73013-3745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 11/02/2014 |