Individual
AMY R THORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
110 BUSINESS PARK DR STE C, BRANSON, MO 65616-7449
(417) 336-0033
Mailing address
PO BOX 1506, ARDMORE, OK 73402-1506
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2016034327
MO
207N00000X
Dermatology Physician
Primary
6265
OK
207N00000X
Dermatology Physician
R3974
TX
Other
Enumeration date
05/13/2013
Last updated
03/18/2020
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