Individual
DR. MATTHEW RYAN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, CHT
Contact information
Practice address
110 N WALMART DR, LOUISVILLE, MS 39339-5905
(662) 779-1096
(669) 779-3949
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-3255
(901) 227-3205
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2366
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0220392
—
MS
Enumeration date
01/11/2011
Last updated
03/17/2018
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