Individual
MRS. TERESA LEE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1685 S SPICELAND RD, NEW CASTLE, IN 47362
(765) 529-4656
(765) 529-4656
Mailing address
1685 S SPICELAND RD, NEW CASTLE, IN 47362
(765) 529-4656
(765) 529-4656
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05001108A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000092221
ANTHEM
—
05
—
20029210A
—
IN
Enumeration date
03/28/2006
Last updated
07/08/2007
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