Provider Demographics
NPI:1437431061
Name:THOMAS, TERESA SUZANNE (DPT)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:SUZANNE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:SUZANNE
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2222 SULLIVAN TRL
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-7958
Mailing Address - Country:US
Mailing Address - Phone:800-944-9782
Mailing Address - Fax:610-438-2046
Practice Address - Street 1:1000 RIVER CENTRE PL
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-7304
Practice Address - Country:US
Practice Address - Phone:770-963-9934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008079225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist