Individual
DANIEL THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1514 CENTRAL AVENUE, LOUISVILLE, KY 40208
(270) 853-7199
Mailing address
1514 CENTRAL AVE, LOUISVILLE, KY 40208-1033
(270) 853-7199
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001725A
IN
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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