Provider Demographics
NPI:1346824513
Name:THOMAS, VIRGINIA (PT,DPT)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 DICKERSON BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-2884
Mailing Address - Country:US
Mailing Address - Phone:704-283-6700
Mailing Address - Fax:
Practice Address - Street 1:1730 DICKERSON BLVD STE D
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-2884
Practice Address - Country:US
Practice Address - Phone:704-283-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20253225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist