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Individual
KENNETH FRED THOMAS JR.
Active
Individual
KENNETH FRED THOMAS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
DAPT002916
PA
225100000X
Physical Therapist
Primary
PT021720
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026544360029
—
PA
01
—
768441
MEDICARE
PA
Enumeration date
11/03/2011
Last updated
12/06/2019
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