Provider Demographics
NPI:1285867325
Name:TOMALIS, ERIC A (DPT, OCS, CSCS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:A
Last Name:TOMALIS
Suffix:
Gender:M
Credentials:DPT, OCS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BUILDING 786 D STREET
Mailing Address - Street 2:PHYSICAL THERAPY
Mailing Address - City:JBER
Mailing Address - State:AK
Mailing Address - Zip Code:99505-7490
Mailing Address - Country:US
Mailing Address - Phone:907-384-3689
Mailing Address - Fax:
Practice Address - Street 1:786 D STREET
Practice Address - Street 2:PHYSICAL THERAPY
Practice Address - City:FORT RICHARDSON
Practice Address - State:AK
Practice Address - Zip Code:99505-7490
Practice Address - Country:US
Practice Address - Phone:907-384-3689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL-11061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist