Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 0140 | AZ |
NPI | 1023220068 |
---|---|
Provider Name | Dr. Thomas Lv Lodi |
First Address | Mesa, AZ 85201-6600 |
Second Address | Mesa, AZ 85201-6600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 08/07/2007 |