Individual
MISS MARCIA VIDETTE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2993 SUNSET BLVD, WEST COLUMBIA, SC 29169-3421
(803) 939-0026
Mailing address
308 IVY HILL CT, LEXINGTON, SC 29072-8097
(803) 808-4463
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2654
SC
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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