Provider Demographics
NPI:1346578473
Name:HUDSON, THOMAS MARION (PT, MS)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MARION
Last Name:HUDSON
Suffix:
Gender:M
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16504-1006
Mailing Address - Country:US
Mailing Address - Phone:814-454-1534
Mailing Address - Fax:814-452-6723
Practice Address - Street 1:226 E 27TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16504-1006
Practice Address - Country:US
Practice Address - Phone:814-454-1534
Practice Address - Fax:814-452-6723
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT000517E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist