Individual
PETER THISTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
313 S 5TH ST, ODESSA, DE 19730-2078
(302) 376-4128
Mailing address
313 S 5TH ST, ODESSA, DE 19730-2078
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
U1-0002090
DE
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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