Individual
ASSYRIAN LANE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3415 30TH LN E, BRADENTON, FL 34208-7248
(941) 226-3404
Mailing address
3415 30TH LN E, BRADENTON, FL 34208-7248
(941) 226-3404
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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