Individual
MRS. SHANNON MICHELLE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-2522
Mailing address
4114 NW 62ND ST, OKLAHOMA CITY, OK 73112-1351
(405) 808-0936
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
753
OK
Other
Enumeration date
08/09/2006
Last updated
05/16/2012
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