Provider Demographics
NPI:1922869411
Name:THOMAS JESSIE, PERMELIA CATINA
Entity Type:Individual
Prefix:MRS
First Name:PERMELIA
Middle Name:CATINA
Last Name:THOMAS JESSIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N MAIN ST STE 115
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-4509
Mailing Address - Country:US
Mailing Address - Phone:770-875-6225
Mailing Address - Fax:
Practice Address - Street 1:301 N MAIN ST STE 115
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-4509
Practice Address - Country:US
Practice Address - Phone:770-875-6225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist