Provider Demographics
NPI:1528011939
Name:THOMAS, HEATHER MARIE WILKES (PT MPH CSCS)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MARIE WILKES
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PT MPH CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:825 E WARNER RD
Mailing Address - Street 2:SUITE C-100
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-0994
Mailing Address - Country:US
Mailing Address - Phone:480-722-0300
Mailing Address - Fax:480-722-0302
Practice Address - Street 1:825 E WARNER RD
Practice Address - Street 2:SUITE C-100
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-0994
Practice Address - Country:US
Practice Address - Phone:480-722-0300
Practice Address - Fax:480-722-0302
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ4037225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ73232Medicare ID - Type Unspecified