Individual
CORNELIA THOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
13732 61ST AVE SE, EVERETT, WA 98208-9405
(360) 631-9969
Mailing address
13732 61ST AVE SE, EVERETT, WA 98208-9405
(360) 631-9969
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60184219
WA
Other
Enumeration date
02/09/2011
Last updated
02/09/2011
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