Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1043482300 |
---|---|
Provider Name | Kathryn A Thomas |
First Address | Mitchell, SD 57301-4402 |
Second Address | Mitchell, SD 57301-4402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2008 |
Last Update Date | 27/03/2008 |