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Individual

ALEATHA D DESHIELDS THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
DUMC 3885 M04 DAVISON BLDG, DURHAM, NC 27710-0001
(919) 684-2474
(919) 681-8496
Mailing address
DUMC 3885 M04 DAVISON BLDG, DURHAM, NC 27710-0001
(919) 684-2474
(919) 681-8496

Taxonomy

Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
T36435
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
T36435
BOC MASTECTOMY FITTER
Enumeration date
04/25/2008
Last updated
04/25/2008
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