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1861796625
CONSTANCE SMYTH THOMAS
PHOENIX, AZ
NPI
1861796625
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209003769)
Enumeration Date
2011-01-07
Last Update Date
2011-01-07
Business Address
-- CONSTANCE SMYTH THOMAS NP
4545 E SHEA BLVD SUITE 175
PHOENIX, AZ 85028-3074
Phone number: 602-464-5251
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Mailing Address
-- CONSTANCE SMYTH THOMAS NP
1113 W CHURCH ST
CHAMPAIGN, IL 61821-2743
Phone number: 217-355-4753
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