Individual
CHARLES THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 BAPTIST DR, SUITE 306, MADISON, MS 39110-2009
(601) 607-7204
Mailing address
401 BAPTIST DR, SUITE 306, MADISON, MS 39110-2009
(601) 607-7204
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA3360
MS
Other
Enumeration date
12/03/2015
Last updated
12/03/2015
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