Most Relevant Information
Provider Data
| NPI Number: | 1003315151 |
| Provider Name: | THOMAS CHARLES KINNE |
| Entity Type: | Individual |
| Taxonomy Code: | 385H00000X |
| Specialty: | Respite Care |
| License Number: | 8876774 |
Most Important Dates
| Enumeration Date: | 02/05/2018 |
| Last Updated: | 02/05/2018 |
Provider Practice Location
314 ASPEN STREET
FREDONIA
AZ
86022
Practice Location Phone/Fax
| Phone: | 9289255992 |
| Fax: |
Provider Mailing Location
PO BOX 491
FREDONIA
AZ
860220491
Provider Mailing Phone/Fax
| Phone: | 9289255992 |
| Fax: |