Provider Demographics
NPI:1184321911
Name:THOMAS, MERIGAN ANSLEY
Entity type:Individual
Prefix:
First Name:MERIGAN
Middle Name:ANSLEY
Last Name:THOMAS
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 1:84 RILEY RD APT C102
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533-0850
Mailing Address - Country:US
Mailing Address - Phone:770-880-6489
Mailing Address - Fax:
Practice Address - Street 1:5310 FALLS DR APT 1308
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30028-3541
Practice Address - Country:US
Practice Address - Phone:770-880-6489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer