Healthcare Provider Details

I. General information

NPI: 1568479855
Provider Name (Legal Business Name): THOMAS JOSEPH STONE DPT, ATC, OCS, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 11/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 BOSTON ST
BALTIMORE MD
21224-4981
US

IV. Provider business mailing address

1774 WESTON AVE
PARKVILLE MD
21234-3735
US

V. Phone/Fax

Practice location:
  • Phone: 410-522-2177
  • Fax: 410-522-2178
Mailing address:
  • Phone: 410-274-0045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number21164
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number21164
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number21164
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: