Basic Information
| Provider Information | |||||||||
| NPI: | 1730278078 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2416 HIGHWAY 45 N | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | MS | ||||||||
| PostalCode: | 397051320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6013559624 | ||||||||
| FaxNumber: | 6013536151 | ||||||||
| Practice Location | |||||||||
| Address1: | 276 NISSAN PKWY | ||||||||
| Address2: | SUITE 400, BLDG F | ||||||||
| City: | CANTON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 390467006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6018593776 | ||||||||
| FaxNumber: | 6018593778 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2006 | ||||||||
| LastUpdateDate: | 11/30/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT0271 | MS | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.