Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 5501013434 | MI |
NPI | 1003009739 |
---|---|
Provider Name | Rachelle Marie Thomas |
First Address | East Lansing, MI 48824-7015 |
Second Address | East Lansing, MI 48823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2007 |
Last Update Date | 02/08/2018 |