Provider Demographics
NPI:1316454879
Name:THOMAS, TORI PEYTON (PT, DPT, ATC)
Entity type:Individual
Prefix:
First Name:TORI
Middle Name:PEYTON
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:TORI
Other - Middle Name:PEYTON
Other - Last Name:HERNDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 903
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24212-0903
Mailing Address - Country:US
Mailing Address - Phone:276-596-3324
Mailing Address - Fax:
Practice Address - Street 1:272 HIGHLAND DR # 4666
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:VA
Practice Address - Zip Code:24266-4666
Practice Address - Country:US
Practice Address - Phone:276-889-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260029452255A2300X
VA2305214873225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer