Individual
FANKIE THURSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5100 N KINGS HWY LOT 48, TEXARKANA, TX 75503-1069
(903) 831-3198
Mailing address
5100 N KINGS HWY LOT 48, TEXARKANA, TX 75503-1069
(903) 831-3198
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
205027
TX
Other
Enumeration date
08/24/2007
Last updated
08/24/2007
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