Andrea Nicole Thomas PAC

NPI 1538152657 - Physician Assistant - 363A00000X

NPI Details
NPI 1538152657
Gender Female
Enumeration Date 08/24/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
509 HAMACHER ST
SUITE 102
WATERLOO IL, 62298, US
Phone (618) 939-3939
Fax (618) 939-3941
Business Location
9476 TRILLIUM DR
ST LOUIS MO, 63126, US
Phone (314) 842-5848
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Missouri
License Number 2001016022
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According to our database, Andrea Nicole Thomas PAC NPI is 1538152657, taxonomy code is 363A00000X and license number is 2001016022, license state is located at Missouri. Andrea Nicole Thomas PAC physically located at 509 Hamacher St, Waterloo IL, 62298. NPI Number Andrea Nicole Thomas PAC has the Individual type.

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1538152657 NPI number is provided on an as is basis without warranty of any kind. 1538152657 is maintained by the National Plan & Provider Enumeration System. The contents of Andrea Nicole Thomas PAC are for informational purposes only.