Provider Demographics
NPI:1407821093
Name:HARMON, THOMAS (ATC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:HARMON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 S MORRISON RD
Mailing Address - Street 2:APT. 75
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-4043
Mailing Address - Country:US
Mailing Address - Phone:765-760-0099
Mailing Address - Fax:
Practice Address - Street 1:1601 E 26TH ST
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47302-5808
Practice Address - Country:US
Practice Address - Phone:765-760-0099
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36001102A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer