Provider Demographics
NPI:1386079739
Name:ECK, THOMAS DANIEL (DPT)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DANIEL
Last Name:ECK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 869
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35652-0869
Mailing Address - Country:US
Mailing Address - Phone:256-764-4242
Mailing Address - Fax:256-764-4343
Practice Address - Street 1:48 MARKET SQUARE
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35652
Practice Address - Country:US
Practice Address - Phone:256-764-4242
Practice Address - Fax:256-764-4343
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-04
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH80942081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine