Individual
THOMAS THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15501 BUSTLETON AVE, SUITE #1, PHILADELPHIA, PA 19116-1187
(215) 642-8218
Mailing address
15501 BUSTLETON AVE, SUITE #1, PHILADELPHIA, PA 19116-1187
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT025285
PA
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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