Provider Demographics
NPI:1437323987
Name:NUMMY, THOMAS J (LMT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:J
Last Name:NUMMY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-2431
Mailing Address - Country:US
Mailing Address - Phone:850-769-3602
Mailing Address - Fax:850-785-5822
Practice Address - Street 1:1138 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-2431
Practice Address - Country:US
Practice Address - Phone:850-769-3602
Practice Address - Fax:850-785-5822
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA34419225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist