Provider Demographics
NPI:1033307087
Name:THOMAS, MICHELLE P (PT)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:P
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6321 ROSS BND
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-8590
Mailing Address - Country:US
Mailing Address - Phone:614-204-1708
Mailing Address - Fax:
Practice Address - Street 1:1504 W 1ST AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3427
Practice Address - Country:US
Practice Address - Phone:614-485-2347
Practice Address - Fax:614-485-2561
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10393225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist