Individual
JACOB WADE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
224 W COMMERCIAL ST, LEBANON, MO 65536-3146
(417) 657-6400
Mailing address
12418 BLUFFVIEW LN, PLATO, MO 65552-7800
(417) 664-7460
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
2022005065
MO
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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