MEDICARE: MR. ROBERT E THOMAS MSPT, LATC

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	15629	MA

General Provider Information

NPI Number	:	1053385427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT E THOMAS MSPT, LATC

Provider Business Mailing Address
First Line	:	411 MASS AVE
Second Line	:	SUITE 302
City	:	ACTON
State	:	MA
Zip	:	01720-3739
Country	:	US
Telephone Number	:	978-263-0007
Fax Number	:	978-263-0014

Provider Business Practice Location Address
First Line	:	411 MASS AVE
Second Line	:	SUITE 302
City	:	ACTON
State	:	MA
Zip	:	01720-3739
Country	:	US
Telephone Number	:	978-263-0007
Fax Number	:	978-263-0014

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

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	04/10/2014

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