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Individual

LETICIA THOMASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7755 22 MILE RD #183166, SHELBY TWP, MI 48318
(586) 484-9111
(586) 200-0118
Mailing address
PO BOX 183166, SHELBY TWP, MI 48318
(586) 484-9111
(586) 200-0118

Taxonomy

Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
7501008057
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7501008057
STATE LICENSE
MI
Enumeration date
03/09/2015
Last updated
03/09/2015
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