MEDICARE: KIERRA DELAINE THOMAS

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	P24700	NC

General Provider Information

NPI Number	:	1780535617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIERRA DELAINE THOMAS

Provider Business Mailing Address
First Line	:	1405 DUBLIN PL
Second Line	:
City	:	MONROE
State	:	NC
Zip	:	28112-8443
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1321 E SUNSET DR
Second Line	:
City	:	MONROE
State	:	NC
Zip	:	28112-4324
Country	:	US
Telephone Number	:	704-248-6974
Fax Number	:

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

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	03/09/2026

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Directions to “ KIERRA DELAINE THOMAS ” Practice Location

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