Provider Demographics
NPI:1568580702
Name:BARBIE THOMAS PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:BARBIE THOMAS PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:951-218-6787
Mailing Address - Street 1:25125 CLINTON KEITH RD
Mailing Address - Street 2:
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-7708
Mailing Address - Country:US
Mailing Address - Phone:951-218-6787
Mailing Address - Fax:951-813-3899
Practice Address - Street 1:25125 CLINTON KEITH RD
Practice Address - Street 2:
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-7708
Practice Address - Country:US
Practice Address - Phone:951-218-6787
Practice Address - Fax:951-813-3899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT20758261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ05322ZMedicare PIN