Individual
DEREK THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6700 HIGHWAY 165 N, MONROE, LA 71203-8753
(318) 625-4709
Mailing address
4109 HIGHWAY 98 W, SUMMIT, MS 39666-9132
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
Z20245
LA
Other
Enumeration date
01/21/2010
Last updated
01/21/2010
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