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General NPI Number Information
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NPI Number | 1902783244
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Entity Type | Individual
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Provider Name | WILLIAM CHANEY THOMAS PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 209 COOLEY WAY STE 203
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City | VILLA RICA
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State | GA
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Zip | 30180-7057
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Country | US
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Telephone | 770-917-0826
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Fax |
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Provider Business Mailing Address
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Address Line | 240 CHURCH ST
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City | BREMEN
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State | GA
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Zip | 30110-1815
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Country | US
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Telephone | 770-825-2099
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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 | PT017934
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License Number State | GA
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