Healthcare Provider Details

I. General information

NPI: 1962465328
Provider Name (Legal Business Name): ALICIA F THOMAS ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 WILLOW ST
VINCENNES IN
47591-5355
US

IV. Provider business mailing address

1302 N 12TH ST
VINCENNES IN
47591-3307
US

V. Phone/Fax

Practice location:
  • Phone: 812-882-1141
  • Fax: 812-886-6333
Mailing address:
  • Phone: 812-887-7733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number36000768A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number06004146A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: