Individual
CLINT BRADLEY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT, CHT
Contact information
Practice address
3575 KEITH ST NW, STE 205, CLEVELAND, TN 37312-4324
(423) 559-0444
(423) 559-0103
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2819
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1506784
—
TN
Enumeration date
09/10/2008
Last updated
09/11/2014
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