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Individual

SIDNEY RONALD THOMAS III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
917 N CATALINA AVE, TUCSON, AZ 85711-1130
(520) 881-0721
Mailing address
917 N CATALINA AVE, TUCSON, AZ 85711-1130

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
ALH-6244
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
315971
AHCCS
AZ
Enumeration date
05/02/2008
Last updated
05/02/2008
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