Healthcare Provider Details
I. General information
NPI: 1316632193
Provider Name (Legal Business Name): THOMAS WINSTON TURNER LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/07/2023
Last Update Date: 04/07/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3132 OLD WETUMPKA HWY
MONTGOMERY AL
36110
US
IV. Provider business mailing address
5759 BRIDLE PATH LN APT 734
MONTGOMERY AL
36116-1048
US
V. Phone/Fax
- Phone: 334-498-4107
- Fax:
- Phone: 770-881-1457
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 6148 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: