Individual
JESSICA THOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6035 ECKHERT RD, SAN ANTONIO, TX 78240-3164
(210) 642-5300
Mailing address
2039 W KINGSBURY ST, SEGUIN, TX 78155-3023
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2113252
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2113252
PHYSICAL THERAPIST ASSISTANCE LICENSE
—
Enumeration date
09/23/2018
Last updated
09/23/2018
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