Provider Demographics
NPI:1366710642
Name:LAFONTAINE, THOMAS PAUL (PHD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PAUL
Last Name:LAFONTAINE
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:6307 S OLD VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-9533
Mailing Address - Country:US
Mailing Address - Phone:573-673-6700
Mailing Address - Fax:573-442-2581
Practice Address - Street 1:200 E SOUTHAMPTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-9533
Practice Address - Country:US
Practice Address - Phone:573-777-7474
Practice Address - Fax:573-777-7484
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist