Individual
ANGEL CLARESE THORNTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
637 HIGHLAND AVE, TOLEDO, OH 43610-1144
(419) 246-7014
Mailing address
637 HIGHLAND, TOLEDO, OH 43610
(419) 246-7014
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
UG063459
—
OH
Enumeration date
07/13/2017
Last updated
07/21/2022
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