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General NPI Number Information
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NPI Number | 1497253066
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Entity Type | Individual
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Provider Name | CHRISTE ANNE THOMAS ATC
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Gender | Female
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Dates
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Enumeration Date | 01/29/2018
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Last Update Date | 01/29/2018
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Provider Practice Location Address
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Address Line | 1 COLLEGE HL # 133
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City | CANTON
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State | MO
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Zip | 63435-1257
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Country | US
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Telephone | 573-288-6332
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Fax |
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Provider Business Mailing Address
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Address Line | 2819 CABOT RD
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City | QUINCY
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State | IL
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Zip | 62301-6272
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Country | US
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Telephone | 217-653-2710
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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 |
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License Number State | IL
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