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1366001992
MICHELLE ANNETTE THACKER
SAN ANTONIO, TX
NPI
1366001992
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164X00000X Licensed Vocational Nurse
(Licence: TX 320923)
Enumeration Date
2019-06-07
Last Update Date
2019-06-07
Business Address
MICHELLE ANNETTE THACKER
7710 W IH 10
SAN ANTONIO, TX 78230-4711
Phone number: 210-377-3355
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Mailing Address
MICHELLE ANNETTE THACKER
7710 W IH 10
SAN ANTONIO, TX 78230-4711
Phone number:
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