Individual
LONNIE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8097 HIGH STREET, MONTEZUMA, NY 13117
(315) 776-4935
Mailing address
8097 HIGH ST, MONTEZUMA, NY 13117-1715
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
308442
NY
Other
Enumeration date
09/08/2017
Last updated
09/08/2017
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