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NPI 1871456988

NPI 1871456988 : AUTUMN THOMAS : IRWIN, PA

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General NPI Number Information
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    NPI Number           |    1871456988
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    Entity Type          |    Individual 
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    Provider Name        |    AUTUMN THOMAS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/05/2025
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    Last Update Date     |    12/05/2025
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Provider Practice Location Address
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    Address Line         |    12320 LINCOLN HWY E 
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    City                 |    IRWIN
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    State                |    PA
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    Zip                  |    15642-2590
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    Country              |    US
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    Telephone            |    412-401-3783
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    515 LUDWIG ST 
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    City                 |    GREENOCK
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    State                |    PA
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    Zip                  |    15047-1137
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    Country              |    US
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    Telephone            |    412-656-1497
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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        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    MSG016663
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    License Number State |    PA
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