Individual
GENETTA LATICE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1423 DANTZLER DR APT I, CINCINNATI, OH 45215-1933
(513) 388-7229
Mailing address
1423 DANTZLER DR APT I, CINCINNATI, OH 45215-1933
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
129982
OH
Other
Enumeration date
10/20/2010
Last updated
10/20/2010
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