Provider Demographics
NPI:1497148795
Name:LAIR, THOMAS (PT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:LAIR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MEDICAL CAMPUS DR NW
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SUPPLY
Mailing Address - State:NC
Mailing Address - Zip Code:28462-4096
Mailing Address - Country:US
Mailing Address - Phone:910-755-5861
Mailing Address - Fax:910-755-5865
Practice Address - Street 1:20 MEDICAL CAMPUS DR NW
Practice Address - Street 2:SUITE 204
Practice Address - City:SUPPLY
Practice Address - State:NC
Practice Address - Zip Code:28462-4096
Practice Address - Country:US
Practice Address - Phone:910-755-5861
Practice Address - Fax:910-755-5865
Is Sole Proprietor?:No
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC151522251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic