Provider Demographics
NPI:1720195514
Name:MELISSA THOMAS LLC
Entity Type:Organization
Organization Name:MELISSA THOMAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MS RD
Authorized Official - Phone:804-338-6966
Mailing Address - Street 1:1312 AMHERST AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-4021
Mailing Address - Country:US
Mailing Address - Phone:804-338-6966
Mailing Address - Fax:804-918-1017
Practice Address - Street 1:1312 AMHERST AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-4021
Practice Address - Country:US
Practice Address - Phone:804-338-6966
Practice Address - Fax:804-918-1017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty