Thomas, Kelly Joe

Thomas, Kelly Joe is an individual health care provider with primary practice located at 3200 Canyon Lake Dr , Rapid City SD 57702-8114. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Medical Technologist, which is considered as his primary health care specialty. Thomas, Kelly Joe can be contacted via phone (605) 355-2229.

Contact Information

Primary practice address
3200 Canyon Lake Dr Rapid City SD 57702-8114
Phone: (605) 355-2229
Fax: (305) 355-2514
Website:
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Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Medical Technologist 246QM0706X 204742
Technologists, Technicians & Other Technical Service Providers / Medical Technologist 246QM0706X 206256

Profile Details

NPI number 1255663670
LBN Legal business name Thomas, Kelly Joe
Credentials BS MT(ASCP) CLS(NCA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 10th, 2010
Last updated Feb 10th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255663670 NPPES
South Dakota MEDICAID 0140070
South Dakota Other 5549050

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