Provider Demographics
NPI:1346910437
Name:RICE, THOMAS (PTA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:RICE
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 TENNANT AVE STE F
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-5529
Mailing Address - Country:US
Mailing Address - Phone:408-778-3434
Mailing Address - Fax:
Practice Address - Street 1:605 TENNANT AVE STE F
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-5529
Practice Address - Country:US
Practice Address - Phone:408-778-3434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT6262225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty