Healthcare Provider Details

I. General information

NPI: 1194843904
Provider Name (Legal Business Name): THOMAS E ENGLISH PHYSICAL THERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 FRANK SCOTT PKWY W STE 824
BELLEVILLE IL
62223-5007
US

IV. Provider business mailing address

2810 FRANK SCOTT PKWY W STE 824
BELLEVILLE IL
62223-5007
US

V. Phone/Fax

Practice location:
  • Phone: 618-234-9705
  • Fax: 618-257-0665
Mailing address:
  • Phone: 618-234-9705
  • Fax: 618-257-0665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: