Provider Demographics
NPI:1396080602
Name:THOMAS, ANIL (PT)
Entity type:Individual
Prefix:
First Name:ANIL
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 SW 44TH PL
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-2971
Mailing Address - Country:US
Mailing Address - Phone:954-288-4482
Mailing Address - Fax:
Practice Address - Street 1:600 SHREWSBURY COMMONS AVE
Practice Address - Street 2:SUITE 9A
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361-1616
Practice Address - Country:US
Practice Address - Phone:717-227-2230
Practice Address - Fax:717-227-0509
Is Sole Proprietor?:No
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-022373225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist