Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A01961 | KY |
NPI | 1003923608 |
---|---|
Provider Name | Steven D Thomas |
First Address | Vanceburg, KY 41179-0055 |
Second Address | Vanceburg, KY 41179-0550 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 08/07/2007 |