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General NPI Number Information
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NPI Number | 1578905766
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Entity Type | Individual
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Provider Name | DR. THOMAS ROGERS THORNTON
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Gender | Male
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Dates
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Enumeration Date | 07/29/2013
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Last Update Date | 07/29/2013
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Provider Practice Location Address
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Address Line | 65-1230 MAMALAHOA HWY E 11
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City | KAMUELA
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State | HI
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Zip | 96743-8318
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Country | US
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Telephone | 808-885-7131
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Fax |
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Provider Business Mailing Address
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Address Line | 76-6167 ALII DR
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City | KAILUA KONA
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State | HI
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Zip | 96740-2387
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Country | US
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Telephone | 336-508-2572
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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