Provider Demographics
NPI:1497170567
Name:ENGLE, THOMASINA (ATC)
Entity Type:Individual
Prefix:
First Name:THOMASINA
Middle Name:
Last Name:ENGLE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 PINE ST
Mailing Address - Street 2:APT. 3
Mailing Address - City:STUART
Mailing Address - State:VA
Mailing Address - Zip Code:24171-1505
Mailing Address - Country:US
Mailing Address - Phone:276-229-5142
Mailing Address - Fax:
Practice Address - Street 1:18688 JEB STUART HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:VA
Practice Address - Zip Code:24171-1559
Practice Address - Country:US
Practice Address - Phone:276-229-5142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260017342255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer