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MYRA THUMMA

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1114354057

Individual Registrant:
 MYRA  THUMMA 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
101 MAIN ST  VENETIE, AK 99781 US
Tel: 907-849-8712  Fax: --

Contact information for business:
101 MAIN ST  VENETIE, AK 99781 US
Tel: --  Fax: --

Registration Information:
NPI: 1114354057
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172V00000XOther Service Providers
Community Health Worker

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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