Individual
TONYA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1432 SCENIC DR, HERCULANEUM, MO 63048-1552
(636) 208-1864
Mailing address
1432 SCENIC DR, HERCULANEUM, MO 63048-1552
(636) 208-1864
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
081686
MO
163WL0100X
Lactation Consultant (Registered Nurse)
081686
MO
Other
Enumeration date
05/01/2017
Last updated
05/01/2017
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