Provider Demographics
NPI:1649243825
Name:FRETTE, THOMAS ALLAN (ATC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALLAN
Last Name:FRETTE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8632 S 100TH ST
Mailing Address - Street 2:
Mailing Address - City:LAVISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-3074
Mailing Address - Country:US
Mailing Address - Phone:402-596-0289
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF NEBRASKA AT OMAHA
Practice Address - Street 2:6001 DODGE STREET FH 24
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68182-0001
Practice Address - Country:US
Practice Address - Phone:402-554-2774
Practice Address - Fax:402-554-4971
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE422255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer