Individual
RAVEN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2125 STATE ST STE 3, NEW ALBANY, IN 47150-4972
(812) 949-5575
Mailing address
6703 HILLSIDE DR, PEWEE VALLEY, KY 40056-8031
(502) 876-1598
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/16/2025
Last updated
01/16/2025
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