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NPI Code Detail

MEDICARE: DAN F THOR PA

MEDICARE: DAN F THOR PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant88-PA09NM

General Provider Information

NPI Number : 1134186562
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAN F THOR PA
Provider Business Mailing Address
First Line : 1397 WEIMER RD
Second Line :
City : TAOS
State : NM
Zip : 87571-6253
Country : US
Telephone Number : 575-737-3397
Fax Number :
Provider Business Practice Location Address
First Line : 1397 WEIMER RD
Second Line :
City : TAOS
State : NM
Zip : 87571-6253
Country : US
Telephone Number : 575-737-3397
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2006
Last Update Date : 03/14/2012

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Directions to “ DAN F THOR PA” Practice Location

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