Individual
KELLY MARIE THOMASON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MSPA-C
Contact information
Practice address
12327 STRATFORD DR, CLIVE, IA 50325-8148
(515) 224-7088
(515) 224-9228
Mailing address
12327 STRATFORD DR, CLIVE, IA 50325-8148
(515) 224-7088
(515) 224-9228
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001665
IA
Other
Enumeration date
03/16/2006
Last updated
07/08/2007
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