Individual
THOMAS T STOOTSBERRY
Active
Individual
THOMAS T STOOTSBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
398
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36523
BCBS
NE
01
—
650017454
RR MEDICARE
NE
Enumeration date
10/06/2006
Last updated
03/23/2010
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