Individual
NICHOLAS ALAN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
5750 S 32ND ST, PHOENIX, AZ 85040-3833
(707) 529-6353
Mailing address
5750 S 32ND ST, PHOENIX, AZ 85040-3833
(602) 437-5055
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATR-001160
AZ
Other
Enumeration date
08/14/2019
Last updated
08/14/2019
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