Healthcare Provider Details

I. General information

NPI: 1710920798
Provider Name (Legal Business Name): THOMAS DANIEL FELDMAN MPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 02/01/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HQ MEDDACB UNIT 28037 BLD 700
APO AE
09112
US

IV. Provider business mailing address

CMR 411 BOX 2057
APO AE
09112-0021
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-2368
  • Fax:
Mailing address:
  • Phone: 314-590-3222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number1138303
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14299
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: