Provider Demographics
NPI:1114297413
Name:DOBBS, THOMAS LEE JR (MPT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:LEE
Last Name:DOBBS
Suffix:JR
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 36TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-1005
Mailing Address - Country:US
Mailing Address - Phone:304-917-3660
Mailing Address - Fax:304-917-3674
Practice Address - Street 1:620 NATIONAL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6560
Practice Address - Country:US
Practice Address - Phone:304-230-5601
Practice Address - Fax:304-230-5603
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT002349225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0061219Medicaid
WV3810023356Medicaid
OH0061219Medicaid