Individual
JOHNNY L THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2212 N MARTIN LUTHER KING DR, MILWAUKEE, WI 53212-3126
(414) 759-8963
Mailing address
8709 W HAMPTON AVE, MILWAUKEE, WI 53225-4925
(414) 759-8963
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
0379
WI
Other
Enumeration date
03/24/2017
Last updated
04/03/2017
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