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NPI 1568479855

NPI 1568479855 : THOMAS JOSEPH STONE DPT, ATC, OCS, CSCS : BALTIMORE, MD

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General NPI Number Information
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    NPI Number           |    1568479855
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    Entity Type          |    Individual 
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    Provider Name        |    THOMAS JOSEPH STONE DPT, ATC, OCS, CSCS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/01/2006
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    Last Update Date     |    11/07/2007
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Provider Practice Location Address
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    Address Line         |    3401 BOSTON ST 
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    City                 |    BALTIMORE
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    State                |    MD
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    Zip                  |    21224-4981
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    Country              |    US
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    Telephone            |    410-522-2177
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    Fax                  |    410-522-2178
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Provider Business Mailing Address
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    Address Line         |    1774 WESTON AVE 
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    City                 |    PARKVILLE
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    State                |    MD
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    Zip                  |    21234-3735
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    Country              |    US
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    Telephone            |    410-274-0045
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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        |    2251S0007X
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    Taxonomy Name        |    Sports Physical Therapist
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    License Number       |    21164
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    License Number State |    MD
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    21164
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    License Number State |    MD
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Taxonomy #3
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    Taxonomy Code        |    2251X0800X
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    Taxonomy Name        |    Orthopedic Physical Therapist
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    License Number       |    21164
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    License Number State |    MD
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Taxonomy #4
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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 |    
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