MEDICARE: CECIL HENRY THOMAS

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
1	3747P1801X	Personal Care Attendant	UU094937	OH

General Provider Information

NPI Number	:	1336821511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECIL HENRY THOMAS

Provider Business Mailing Address
First Line	:	283 HURON AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-1621
Country	:	US
Telephone Number	:	312-286-0342
Fax Number	:

Provider Business Practice Location Address
First Line	:	283 HURON AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-1621
Country	:	US
Telephone Number	:	312-286-0342
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2023
Last Update Date	:	08/07/2023

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Directions to “ CECIL HENRY THOMAS ” Practice Location

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