Individual
JIMMY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1410 13TH AVE E, WEST FARGO, ND 58078-3444
(701) 492-0555
Mailing address
900 42ND ST S, FARGO, ND 58103-2119
(800) 633-4227
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
Primary
732830987
VT
Other
Enumeration date
12/27/2021
Last updated
12/27/2021
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