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Individual

MR. MICHAEL CLEVELAND THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5915 NORTHRIDGE RD, COLUMBIA, SC 29206-4335
(803) 315-3737
Mailing address
5915 NORTHRIDGE RD, COLUMBIA, SC 29206-4335
(803) 315-3737

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
03/26/2013
Last updated
03/26/2013
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