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Individual

CANDACE THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1136 SYLVAN AVE, MARTINSVILLE, VA 24112-5208
(276) 226-6917
Mailing address
PO BOX 3426, MARTINSVILLE, VA 24115-3426

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0174177110
VA
Enumeration date
11/20/2016
Last updated
11/02/2018
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