Individual
BREANN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM
Contact information
Practice address
22114 GALLAGHER AVE, CORNING, CA 96021-9379
(530) 586-1203
Mailing address
22114 GALLAGHER AVE, CORNING, CA 96021-9379
(530) 586-1203
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
606
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y2975850
DRIVERS LICENSE
CA
Enumeration date
03/19/2020
Last updated
03/19/2020
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