Individual
MS. SHANON M THRUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4026 W SHORE DR, BREMEN, IN 46506-9364
(574) 248-5484
Mailing address
4026 W SHORE DR, BREMEN, IN 46506-9364
(574) 248-5484
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
09/11/2012
Last updated
09/11/2012
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