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General NPI Number Information
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NPI Number | 1396804381
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Entity Type | Individual
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Provider Name | AMY LOUISE THOMAS ATC, CSCS
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Gender | Female
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4701 LIMESTONE RD
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City | WILMINGTON
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State | DE
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Zip | 19808-1927
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Country | US
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Telephone | 302-225-6217
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Fax | 302-998-6823
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Provider Business Mailing Address
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Address Line | 362 WEDGEWOOD RD
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City | NEWARK
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State | DE
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Zip | 19711-2053
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Country | US
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Telephone | 302-369-2783
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 971337
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License Number State | DE
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