Individual
MR. MARK G THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
725 YOKUM ST, ELKINS, WV 26241-3353
(304) 636-3232
Mailing address
725 YOKUM ST, ELKINS, WV 26241-3353
(304) 636-3232
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639237837
—
WV
Enumeration date
07/29/2020
Last updated
07/29/2020
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