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Individual

LAURA ELIZABETH THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5722 METRO WAY SW STE B, WYOMING, MI 49519-9524
(616) 252-6034
Mailing address
59617 SILVERGRASS DRIVE, MATTAWAN, MI 49071

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000000000000000000
BCBS
MI
Enumeration date
09/24/2018
Last updated
09/24/2018
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