Individual
MS. TRESARAE SHAWN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.C
Contact information
Practice address
2505 US HIGHWAY 431, BOAZ, AL 35957
(256) 593-8310
Mailing address
2570 TURNPIKE RD, ALBERTVILLE, AL 35950-0501
(256) 572-3271
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-430
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009933282
—
AL
01
—
PA-430
ALABAMA STATE LICENSE
AL
Enumeration date
11/30/2005
Last updated
09/25/2013
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