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Individual

MR. THOMAS EDWARD DODSWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN, ANP

Contact information

Practice address
41 AZALEA AVE, FAIRFAX, CA 94930-1527
(510) 381-6346
Mailing address
41 AZALEA AVE, FAIRFAX, CA 94930-1527
(510) 381-6346

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
19160
CA

Other

Enumeration date
07/12/2010
Last updated
06/02/2016
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