Individual
FRED H THOMAS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
331 SE 2ND ST, PENDLETON, OR 97801-2224
(541) 889-9167
(541) 889-7873
Mailing address
PO BOX 1290, ONTARIO, OR 97914-0136
(541) 889-9167
(541) 889-7873
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
XX
OR
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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