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1104213016
KANSAS THOMAS
DETROIT, MI
NPI
1104213016
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: MI 4703114921)
Enumeration Date
2015-04-17
Last Update Date
2015-04-17
Business Address
-- KANSAS THOMAS
8930 APPOLINE ST
DETROIT, MI 48228-2624
Phone number: 313-399-0616
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Mailing Address
-- KANSAS THOMAS
8930 APPOLINE ST
DETROIT, MI 48228-2624
Phone number: 313-399-0616
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