Individual
OLLIE NORMAN THOMAS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1770 BONITA CT, KERNERSVILLE, NC 27284-9960
(336) 564-8957
Mailing address
1770 BONITA CT, KERNERSVILLE, NC 27284-9960
(336) 564-8957
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
NC
Other
Enumeration date
02/08/2018
Last updated
02/08/2018
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