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Individual

DONALD J. THOME

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
2445 MISSOURI AVE, SUITE A, LAS CRUCES, NM 88001-5111
(575) 523-8080
Mailing address
2445 MISSOURI AVE, SUITE A, LAS CRUCES, NM 88001-5111
(575) 523-8080

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
420
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
87087707
NM
01
NM00Q038
BLUE CROSS BLUE SHIELD
NM
01
PROVP15990
MOLINA HEALTH PLAN
NM
Enumeration date
08/01/2006
Last updated
06/16/2014
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