Individual
MRS. CARLY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
1066 N POWER RD STE 101, MESA, AZ 85205-5709
(602) 288-6776
(480) 776-0025
Mailing address
694 W DESERT BROOM DR, CHANDLER, AZ 85248-3844
(503) 621-7381
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
126320
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679133
—
AK
Enumeration date
05/17/2016
Last updated
08/15/2023
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