Individual
BRENDA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1005 LAUREL DR, FLOWOOD, MS 39232-8342
(601) 613-5947
Mailing address
1005 LAUREL DR, FLOWOOD, MS 39232-8342
(601) 613-5947
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
7482316
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7482316
NPN
MS
Enumeration date
02/18/2019
Last updated
02/18/2019
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