Individual
BETHANY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8119 WOODSON DR, OLIVE BRANCH, MS 38654-8098
(901) 326-4054
Mailing address
8850 MIDSOUTH DR, OLIVE BRANCH, MS 38654-2910
(800) 275-8777
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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