Individual
MS. LISA MICHELE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1425 BLUE HILL AVE, MATTAPAN COMMUNITY HEALTH CTR, MATTAPAN, MA 02126
(617) 296-0061
Mailing address
139 SPENCER ST, DORCHESTER, MA 02124
(617) 288-4379
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
270705
MA
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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