Provider Demographics
NPI:1346880754
Name:THOMES, AMANDA MAE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MAE
Last Name:THOMES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 ROOSEVELT TRL STE 2
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-5652
Mailing Address - Country:US
Mailing Address - Phone:207-272-4274
Mailing Address - Fax:
Practice Address - Street 1:936 ROOSEVELT TRL STE 2
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-5652
Practice Address - Country:US
Practice Address - Phone:207-272-4274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT1839225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist