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NPI Code Detail

MEDICARE: DR. THOMAS PAUL LAFONTAINE PH.D.

MEDICARE:  DR. THOMAS PAUL LAFONTAINE  PH.D.
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
1224Y00000XClinical Exercise Physiologist

General Provider Information

NPI Number : 1366710642
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS PAUL LAFONTAINE PH.D.
Provider Business Mailing Address
First Line : 6307 S OLD VILLAGE RD
Second Line :
City : COLUMBIA
State : MO
Zip : 65203-9533
Country : US
Telephone Number : 573-673-6700
Fax Number : 573-442-2581
Provider Business Practice Location Address
First Line : 200 E SOUTHAMPTON RD
Second Line :
City : COLUMBIA
State : MO
Zip : 65203-9533
Country : US
Telephone Number : 573-777-7474
Fax Number : 573-777-7484
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2011
Last Update Date : 12/01/2011

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Directions to “ DR. THOMAS PAUL LAFONTAINE PH.D.” Practice Location

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