Provider Demographics
NPI:1992543599
Name:FINN, THOR MAURICE
Entity type:Individual
Prefix:
First Name:THOR
Middle Name:MAURICE
Last Name:FINN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5312 S OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-8715
Mailing Address - Country:US
Mailing Address - Phone:540-997-3042
Mailing Address - Fax:
Practice Address - Street 1:5312 S OAKS AVE
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-8715
Practice Address - Country:US
Practice Address - Phone:540-997-3042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2710065255171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications