Individual
TIFFANY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1485 M 139, BENTON HARBOR, MI 49022-5711
(269) 925-0585
(269) 927-1326
Mailing address
1485 M 139, BENTON HARBOR, MI 49022-5711
(269) 925-0585
(269) 927-1326
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703118063
MI
Other
Enumeration date
01/07/2019
Last updated
01/07/2019
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