Provider Demographics
NPI:1235322314
Name:THOMAS, HELEN (PTA)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:CHAMPAGNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2915 HIGHWAY 104 N
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:TN
Mailing Address - Zip Code:38321-4027
Mailing Address - Country:US
Mailing Address - Phone:731-535-2568
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:2036 US HIGHWAY 45 BYP S
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:TN
Practice Address - Zip Code:38382-2941
Practice Address - Country:US
Practice Address - Phone:731-855-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5718225200000X
FL28496225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant