Individual
BRAD L THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
169 SPRING CREEK PARK WAY, SUITE 140, PROVIDNCE, UT 84332
(435) 755-8500
(435) 755-2836
Mailing address
169 SPRING CREEK PARK WAY, SUITE 140, PROVIDNCE, UT 84332
(435) 755-8500
(435) 755-2836
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
871176802401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N0741
—
UT
Enumeration date
04/17/2007
Last updated
07/08/2007
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