Provider Demographics
NPI:1306258850
Name:HARMON, THOMAS (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:HARMON
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 KINLEY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-9632
Mailing Address - Country:US
Mailing Address - Phone:803-764-6488
Mailing Address - Fax:803-764-6572
Practice Address - Street 1:1036 KINLEY RD
Practice Address - Street 2:SUITE A
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-9632
Practice Address - Country:US
Practice Address - Phone:803-528-6335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7391225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist