Individual
MICHAEL THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
321 SE 3RD ST, TOLEDO, OR 97391-1613
(541) 336-2254
Mailing address
321 SE 3RD ST, TOLEDO, OR 97391-1613
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
93-0698327
PRIVATE NON PROFIT
—
Enumeration date
03/11/2014
Last updated
03/11/2014
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