Individual
TARSHA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
864 LONGDALE AVE, LONGWOOD, FL 32750-3238
(386) 216-6553
Mailing address
864 LONGDALE AVE, LONGWOOD, FL 32750-3238
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/06/2008
Last updated
02/06/2008
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