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General NPI Number Information
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NPI Number | 1770890980
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Entity Type | Individual
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Provider Name | DEBRA J THOMAS P.T.
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Gender | Female
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Dates
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Enumeration Date | 09/09/2010
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Last Update Date | 07/17/2012
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Provider Practice Location Address
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Address Line | 1200 MAGNOLIA WAY
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City | BLUE SPRINGS
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State | MS
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Zip | 38828-6000
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Country | US
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Telephone | 662-871-4065
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Fax | 662-680-5114
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Provider Business Mailing Address
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Address Line | 342 N SWEET GUM LN
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City | TUPELO
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State | MS
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Zip | 38801-7765
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Country | US
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Telephone | 662-871-4065
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Fax | 662-680-5114
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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 | PT1003
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License Number State | MS
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