MEDICARE: MS. JESSICA LYNN THOMAS DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	033812-1	NY

General Provider Information

NPI Number	:	1023353851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JESSICA LYNN THOMAS DPT

Provider Business Mailing Address
First Line	:	1328 UNIVERSITY AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14607-1622
Country	:	US
Telephone Number	:	585-482-5060
Fax Number	:	585-482-7982

Provider Business Practice Location Address
First Line	:	1328 UNIVERSITY AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14607-1622
Country	:	US
Telephone Number	:	585-482-5060
Fax Number	:	585-482-7982

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2012
Last Update Date	:	03/17/2018

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