Individual
MRS. MILDRED ROMAIN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4658 BOUDINOT ST LOWR LEVEL, PHILADELPHIA, PA 19120-4521
(215) 313-0320
(215) 324-1903
Mailing address
4658 BOUDINOT ST LOWR LEVEL, PHILADELPHIA, PA 19120-4521
(215) 313-0320
(215) 324-1903
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
C70579
PA
Other
Enumeration date
12/30/2020
Last updated
02/27/2024
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