Provider Demographics
NPI:1386602308
Name:HOWELL, THOMAS MICHAEL (MPT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:HOWELL
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 LYNDON FARM CT STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5005
Mailing Address - Country:US
Mailing Address - Phone:856-677-4000
Mailing Address - Fax:856-234-3014
Practice Address - Street 1:1075 VIRGINIA DR STE 200
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-3108
Practice Address - Country:US
Practice Address - Phone:215-619-4545
Practice Address - Fax:215-619-4555
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-012079225100000X
CA18374225100000X
IDRPT-1130225100000X
PAPT007112L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID805242500Medicaid
ID1652019Medicare ID - Type UnspecifiedPROVIDER ID