Provider Demographics
NPI:1629850177
Name:THOMAS, ALYSSA M (LMT)
Entity Type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:M
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2134 NICHOLASVILLE RD STE 12
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2521
Mailing Address - Country:US
Mailing Address - Phone:502-661-1777
Mailing Address - Fax:859-554-5287
Practice Address - Street 1:2134 NICHOLASVILLE RD STE 12
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2521
Practice Address - Country:US
Practice Address - Phone:502-661-1777
Practice Address - Fax:859-554-5287
Is Sole Proprietor?:No
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY279650225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist