Provider Demographics
NPI:1801153374
Name:THOMAS, KENNETH LEE (CNMT)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:LEE
Last Name:THOMAS
Suffix:
Gender:M
Credentials:CNMT
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Mailing Address - Street 1:166 CAROLINA PARADISE RD
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-8332
Mailing Address - Country:US
Mailing Address - Phone:828-305-0289
Mailing Address - Fax:
Practice Address - Street 1:166 CAROLINA PARADISE RD
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-8332
Practice Address - Country:US
Practice Address - Phone:828-305-0289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0329712471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine Technology