MEDICARE: EMILY THOMAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013433390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY THOMAS

Provider Business Mailing Address
First Line	:	1410 N RACE ST
Second Line	:
City	:	GLASGOW
State	:	KY
Zip	:	42141-3473
Country	:	US
Telephone Number	:	270-651-7882
Fax Number	:	270-651-7883

Provider Business Practice Location Address
First Line	:	1410 N RACE ST
Second Line	:
City	:	GLASGOW
State	:	KY
Zip	:	42141-3473
Country	:	US
Telephone Number	:	270-651-7882
Fax Number	:	270-651-7883

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2017
Last Update Date	:	02/01/2022

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Directions to “ EMILY THOMAS ” Practice Location

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