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Individual

KATHERINE SUSANNAH MARY THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 755-3016
Mailing address
7006 CANDLEWICK DR NE, CEDAR RAPIDS, IA 52402-1453
(319) 210-1487

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
096820
IA

Other

Enumeration date
06/11/2019
Last updated
06/11/2019
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