Brian Thomas, ATC, PTA

Individual provider Active NPI Physical Therapy Assistant · Albion, MI

NPI 1255748620 · NPPES record last updated Jul 17, 2014

Key facts

NPI
1255748620
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
5502000396 (MI)
Practice address
300 B Dr N
Albion, MI 49224-8420
Phone
(517) 630-0267
Fax
(517) 630-0271
NPI assigned
Jul 17, 2014
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5502000396MIMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502000396 MI Yes

Addresses

Primary practice location

300 B Dr N
Albion, MI 49224-8420

Mailing address

315 W Allen St
Tekonsha, MI 49092-9421
Phone (517) 414-0520

Other providers in Albion, MI

All providers in Albion, MI · Physical Therapy Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.