Individual
DAN F THOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1397 WEIMER RD, TAOS, NM 87571-6253
(575) 737-3397
Mailing address
1397 WEIMER RD, TAOS, NM 87571-6253
(575) 737-3397
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
88-PA09
NM
Other
Enumeration date
04/28/2006
Last updated
03/14/2012
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