Provider Demographics
NPI:1427161892
Name:WATERS, THOMAS ERIC (ATC, CES, PES)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ERIC
Last Name:WATERS
Suffix:
Gender:M
Credentials:ATC, CES, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 F ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20004-1605
Mailing Address - Country:US
Mailing Address - Phone:202-628-3200
Mailing Address - Fax:202-661-5169
Practice Address - Street 1:601 F ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20004-1605
Practice Address - Country:US
Practice Address - Phone:202-628-3200
Practice Address - Fax:202-661-5169
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer