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General NPI Number Information
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NPI Number | 1649811522
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Entity Type | Organization
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Legal Business Name | CARLA THOMAS PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 10/02/2019
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Last Update Date | 05/03/2021
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Provider Practice Location Address
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Address Line | 303 N 2ND ST STE A
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City | SAINT CHARLES
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State | IL
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Zip | 60174-1804
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Country | US
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Telephone | 331-235-5024
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Fax | 630-281-4619
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Provider Business Mailing Address
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Address Line | 901 JACKSON AVE
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City | ST CHARLES
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State | IL
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Zip | 60174-3025
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Country | US
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Telephone | 630-346-0901
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | CARLA THOMAS
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Credential | MPT
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Telephone | 630-346-0901
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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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