MEDICARE: SCOTT A THOMAS PT

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	21349	FL

General Provider Information

NPI Number	:	1669520193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT A THOMAS PT

Provider Business Mailing Address
First Line	:	11930 GRANITE WOODS LOOP
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34292-4135
Country	:	US
Telephone Number	:	941-493-2487
Fax Number	:

Provider Business Practice Location Address
First Line	:	1279 N SUMTER BLVD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286-8021
Country	:	US
Telephone Number	:	941-240-8602
Fax Number	:	941-240-8607

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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