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Individual

DESIREE THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2021 CHESTER BLVD, RICHMOND, IN 47374-1235
(765) 983-3092
Mailing address
2212 PARKDALE DR, RICHMOND, IN 47374-1642
(812) 243-3913

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002109A
IN
2255A2300X
Athletic Trainer
AT.004133
OH

Other

Enumeration date
09/10/2015
Last updated
09/10/2015
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