Individual
MR. MICHAEL MONTAE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN RN
Contact information
Practice address
4420 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5104
(405) 425-0341
Mailing address
4436 NW 50TH ST, OKLAHOMA CITY, OK 73112-2212
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
83621
OK
Other
Enumeration date
09/01/2011
Last updated
02/28/2019
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