Individual
STEVEN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
142 WHITE ROSE DR, DANIELS, WV 25832-9135
(304) 731-1634
Mailing address
4834 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1340
(304) 346-9586
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E544378
DRIVER'S LICENSE
WV
Enumeration date
11/02/2020
Last updated
11/02/2020
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