Individual
KENDRA R THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HAIR LOSS SPECIALIST
Contact information
Practice address
2396 BATTLE FOREST DR SW, MARIETTA, GA 30064-2629
(720) 472-1452
Mailing address
2396 BATTLE FOREST DR SW, MARIETTA, GA 30064-2629
(720) 472-1452
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CO139925
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO139925
SPECIALIST
GA
Enumeration date
09/06/2021
Last updated
09/06/2021
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