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MRS. JENNIFER LYNN THOMISON D.T.

>> Specialist >> Other Service Providers

Registrant NPI Number: 1366624637

Individual Registrant:
MRS. JENNIFER LYNN THOMISON D.T.
Gender: F
Not Sole Proprietor

Location and contact information for practice:
411 E ELM ST  LE ROY, IL 61752-1535 US
Tel: 309-868-1793  Fax: 309-962-3270

Contact information for business:
411 E ELM ST  LE ROY, IL 61752-1535 US
Tel: 309-868-1793  Fax: 309-962-3270

Registration Information:
NPI: 1366624637
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y174400000XOther Service Providers
Specialist

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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