Individual
MR. THOMAS JOHN MAYTUM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1225 BROADRICK DR, DALTON, GA 30720-2504
(706) 272-6199
(706) 272-6291
Mailing address
1225 BROADRICK DR, DALTON, GA 30720-2504
(706) 272-6199
(706) 272-6291
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA001065
GA
225200000X
Physical Therapy Assistant
PTA15969
FL
Other
Enumeration date
09/06/2007
Last updated
09/06/2007
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