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General NPI Number Information
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NPI Number | 1013826635
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Entity Type | Individual
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Provider Name | THERESA M THORNTON
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Gender | Female
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Dates
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Enumeration Date | 09/02/2026
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Last Update Date | 09/02/2026
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Provider Practice Location Address
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Address Line | 71 BOYKIN LAKES BLVD
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City | PIKE ROAD
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State | AL
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Zip | 36064-3716
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Country | US
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Telephone | 334-233-9973
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 RED VENTURES DR
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City | FORT MILL
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State | SC
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Zip | 29707-5005
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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