Individual
MR. GARY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCSU, CTAT
Contact information
Practice address
1820 SIDEWINDER DR STE 100, PARK CITY, UT 84060-7563
(310) 871-8738
Mailing address
7000 N GREENFIELD DR, PARK CITY, UT 84098-5899
(310) 871-8738
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/18/2017
Last updated
12/18/2017
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