Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 034000 | NY |
N | 2251E1200X | Ergonomics | 034000 | NY |
N | 225XE1200X | Ergonomics | 034000 | NY |
N | 2251G0304X | Physical Therapist - Geriatrics | 034000 | NY |
N | 2251S0007X | Physical Therapist - Sports | 034000 | NY |
N | 2251X0800X | Physical Therapist - Orthopedic | 034000 | NY |
NPI | 1831486976 |
---|---|
Provider Name | Thomas Whitcomb |
First Address | Plattsburgh, NY 12901-2832 |
Second Address | Plattsburgh, NY 12901-2832 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2011 |
Last Update Date | 08/07/2011 |