| NPI | 1205671278 |
|---|---|
| Doing Business As | THE TRAVELING PHYSICIAN ASSISTANT |
| Entity Type | Organization |
| Authorized Contact | DR. TAMARA IDETTE THORN Owner, Operator 704-898-7837 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-08-14 |