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Individual

TOMAS STEWART STILES MCCOMB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSPT CSCS

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3447
OR
225100000X
Physical Therapist
8711
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004583013
BLUE CROSS
OR
Enumeration date
02/22/2006
Last updated
08/16/2013
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