Provider Demographics
NPI:1528343027
Name:THORNE, ERIC W (DPT)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:W
Last Name:THORNE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:104 KINGSTON DR
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24083-2575
Mailing Address - Country:US
Mailing Address - Phone:304-647-3987
Mailing Address - Fax:304-647-3990
Practice Address - Street 1:111 DAVIS STUART RD
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-9549
Practice Address - Country:US
Practice Address - Phone:304-647-3987
Practice Address - Fax:304-647-3990
Is Sole Proprietor?:No
Enumeration Date:2011-10-15
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA2305207120225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist