Individual
MISS AMY BLACK THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1792 MCFARLAND BLVD N, SUITE B, TUSCALOOSA, AL 35406-2185
(205) 342-2546
(205) 342-2540
Mailing address
1792 MCFARLAND BLVD N, SUITE B, TUSCALOOSA, AL 35406-2185
(205) 342-2546
(205) 342-2540
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PTH4261
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04318
CRS PROVIDER #
AL
01
—
515-19572
BLUE CROSS PROVIDER #
AL
Enumeration date
01/12/2006
Last updated
09/06/2007
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