MEDICARE: ROBIN LYN THOMAS P.T.

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	PT005007	GA

General Provider Information

NPI Number	:	1932314523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN LYN THOMAS P.T.

Provider Business Mailing Address
First Line	:	176 MIDWAY ST
Second Line	:
City	:	LEESBURG
State	:	GA
Zip	:	31763-4573
Country	:	US
Telephone Number	:	229-594-3220
Fax Number	:

Provider Business Practice Location Address
First Line	:	251 US HIGHWAY 19 N
Second Line	:
City	:	CAMILLA
State	:	GA
Zip	:	31730-1410
Country	:	US
Telephone Number	:	229-336-8255
Fax Number	:	229-336-5878

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

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	07/08/2007

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