Provider Demographics
NPI:1619556214
Name:THOMAS, JEFFERY BUTLER (LPN, NBC-HWC)
Entity Type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:BUTLER
Last Name:THOMAS
Suffix:
Gender:M
Credentials:LPN, NBC-HWC
Other - Prefix:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:605 SE 23RD ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-2544
Mailing Address - Country:US
Mailing Address - Phone:503-367-7000
Mailing Address - Fax:
Practice Address - Street 1:2489 DIPLOMAT PKWY E
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-5422
Practice Address - Country:US
Practice Address - Phone:239-652-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
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