Individual
TIANA SUMMER THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
328 LODGEPOLE CIR, PARACHUTE, CO 81635-9576
(970) 366-8836
Mailing address
328 LODGEPOLE CIR, PARACHUTE, CO 81635-9576
(970) 366-8836
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
013020641
CO
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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