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General NPI Number Information
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NPI Number | 1962436048
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Entity Type | Individual
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Provider Name | THOMAS MARK PAPKE P.T.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 500 MONTGOMERY ST SUITE 400
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City | ALEXANDRIA
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State | VA
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Zip | 22314-1565
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Country | US
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Telephone | 540-675-3090
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Fax | 540-675-3058
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Provider Business Mailing Address
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Address Line | 1316 NEW HAMPSHIRE AVE NW APT. 402
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City | WASHINGTON
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State | DC
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Zip | 20036-6351
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Country | US
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Telephone | 202-744-7811
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number | 6299
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License Number State | VA
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