Provider Demographics
NPI:1407255409
Name:TOMASSO, JAMES (PTA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:TOMASSO
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 1:2907 W CARSON ROAD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-6340
Mailing Address - Country:US
Mailing Address - Phone:602-374-8418
Mailing Address - Fax:
Practice Address - Street 1:2907 W CARSON RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-6340
Practice Address - Country:US
Practice Address - Phone:602-374-8418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10969A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant