Provider Demographics
NPI:1659557791
Name:THOMAS, JOI CAROL (LAC)
Entity Type:Individual
Prefix:MS
First Name:JOI
Middle Name:CAROL
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2516 18TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4010
Mailing Address - Country:US
Mailing Address - Phone:612-724-4782
Mailing Address - Fax:
Practice Address - Street 1:2516 18TH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4010
Practice Address - Country:US
Practice Address - Phone:612-724-4782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-19
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1424171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist