Provider Demographics
NPI:1790135143
Name:THON, JENNIFER JO (BA)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JO
Last Name:THON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17435 GRABOWSKI RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MI
Mailing Address - Zip Code:48655-9758
Mailing Address - Country:US
Mailing Address - Phone:989-239-7040
Mailing Address - Fax:
Practice Address - Street 1:17435 GRABOWSKI RD
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MI
Practice Address - Zip Code:48655-9758
Practice Address - Country:US
Practice Address - Phone:989-239-7040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-16
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other