Individual
MR. JEROME LOUIE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
86 W UNIVERSITY DR STE 101, MESA, AZ 85201-5856
(602) 538-9084
Mailing address
86 W UNIVERSITY DR STE 101, MESA, AZ 85201-5856
(602) 538-9084
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
MT-00485-P
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17
LICENSED MASSAGE THERAPIST
AZ
Enumeration date
03/13/2013
Last updated
03/13/2013
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