Individual
JEREMY ROWAN THATCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 FAIRLAND DR, NITRO, WV 25143-1186
(304) 552-2054
Mailing address
130 STONE ST, CULLODEN, WV 25510
(304) 552-2054
Taxonomy
Speciality
Code
Description
License number
State
126900000X
Dental Laboratory Technician
Primary
—
—
Other
Enumeration date
12/10/2021
Last updated
12/10/2021
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