Individual
MR. THOMAS WAYNE HATCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1250 NE TYLER AVE, PRINEVILLE, OR 97754-1349
(541) 447-8636
Mailing address
1250 NE TYLER AVE, PRINEVILLE, OR 97754-1349
(541) 447-8636
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13471
OR
Other
Enumeration date
11/15/2007
Last updated
11/15/2007
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