| Doctor Name: | DANIEL ADAM THIES |
| NPI Number: | 1841301462 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.O., C.O. |
| License Number: | 11 |
| Business Practice Address: | 13809 S Casper St Suite A Glenpool, OK - 740332618 |
| Business Phone Number: | 9185185980 |
| Business Fax Number: | 9185185982 |
| Mailing Address: | 13809 S Casper St, Suite A GLENPOOL |
| State: | OK |
| Postal Code: | 740332618 |
| Phone Number: | 9185185980 |
| Fax Number: | 9185185982 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 06/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246Z00000X |
| License Number: | 11 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Specialist/Technologist, Other |
| Taxonomy Specialization: | |
| Taxonomy Definition: | General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |