Individual
THADDAEUS M VAICHUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
(937) 257-5523
Mailing address
307 BOATNER RD, EGLIN AFB, FL 32542-1302
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1235705
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Enumeration date
07/19/2024
Last updated
03/25/2025
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