Provider Demographics
NPI:1528138179
Name:NUZUM, THOMAS ROBERT (PT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ROBERT
Last Name:NUZUM
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:2154 PARDOROYAL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1935
Mailing Address - Country:US
Mailing Address - Phone:314-821-8304
Mailing Address - Fax:800-327-1957
Practice Address - Street 1:2001 S HANLEY RD
Practice Address - Street 2:SUITE 190
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63144-1518
Practice Address - Country:US
Practice Address - Phone:314-821-8304
Practice Address - Fax:800-327-1957
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2008-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO111974225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist