Provider Demographics
NPI:1083678460
Name:MASTERS, THOMAS JR (PT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:MASTERS
Suffix:JR
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 1:1202 BEND RD
Mailing Address - Street 2:
Mailing Address - City:MERCER
Mailing Address - State:PA
Mailing Address - Zip Code:16137-2510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3140 HIGHLAND RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-4514
Practice Address - Country:US
Practice Address - Phone:724-347-6660
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015536225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist