Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 4439 | OK |
NPI | 1306118518 |
---|---|
Provider Name | Melanie Susan Thomas |
First Address | Oklahoma City, OK 73134-6069 |
Second Address | Oklahoma City, OK 73134-6069 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2012 |
Last Update Date | 02/02/2012 |