Healthcare Provider Details

I. General information

NPI: 1790871242
Provider Name (Legal Business Name): CHERYL LAMBERT THAMES PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 AIRPORT BLVD.
MOBILE AL
36607
US

IV. Provider business mailing address

2006 AIRPORT BLVD.
MOBILE AL
36607
US

V. Phone/Fax

Practice location:
  • Phone: 251-450-0070
  • Fax: 251-450-0072
Mailing address:
  • Phone: 251-450-0070
  • Fax: 251-450-0072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPTH2831
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: