Healthcare Provider Details

I. General information

NPI: 1013433390
Provider Name (Legal Business Name): EMILY THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2017
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 N RACE ST
GLASGOW KY
42141-3473
US

IV. Provider business mailing address

1410 N RACE ST
GLASGOW KY
42141-3473
US

V. Phone/Fax

Practice location:
  • Phone: 270-651-7882
  • Fax: 270-651-7883
Mailing address:
  • Phone: 270-651-7882
  • Fax: 270-651-7883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: