Healthcare Provider Details

I. General information

NPI: 1972636124
Provider Name (Legal Business Name): PAULE E THOMAS OTD, OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 HARRISON AVE
EUREKA CA
95501
US

IV. Provider business mailing address

1701 HAMMOND DR
EMPORIA KS
66801-5312
US

V. Phone/Fax

Practice location:
  • Phone: 707-445-5111
  • Fax:
Mailing address:
  • Phone: 620-342-2969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number9204
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: