Healthcare Provider Details

I. General information

NPI: 1114857836
Provider Name (Legal Business Name): JAMES TODD THONE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 UNIVERSITY AVE SE APT 603
MINNEAPOLIS MN
55414-2863
US

IV. Provider business mailing address

1000 UNIVERSITY AVE SE APT 603
MINNEAPOLIS MN
55414-2863
US

V. Phone/Fax

Practice location:
  • Phone: 920-207-6702
  • Fax:
Mailing address:
  • Phone: 920-207-6702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number5462
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: