Individual
PHILIP THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(770) 339-2395
(678) 990-3997
Mailing address
107 NORTHDALE PL, LAWRENCEVILLE, GA 30046-4571
(770) 995-8141
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN215551
GA
Other
Enumeration date
01/08/2013
Last updated
01/08/2013
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