Individual
ROBERTA A THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
399 S UNION ST APT 15, SPARTA, MI 49345-1534
(708) 738-5533
Mailing address
399 S UNION ST APT 15, SPARTA, MI 49345-1534
(708) 738-5533
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703097705
MI
Other
Enumeration date
09/25/2020
Last updated
09/25/2020
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