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Individual

MR. THOMAS RICHARD MASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
1095 UNIVERSITY DR, EDWARDSVILLE, IL 62025-3961
(618) 656-1081
Mailing address
12251 HIGHWAY 41 N, SUITE A, EVANSVILLE, IN 47725-7014
(314) 753-2102

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.00100
IL

Other

Enumeration date
12/02/2014
Last updated
12/02/2014
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