Provider Demographics
NPI:1659024784
Name:THOMAS, ZACHARY (PT, DPT, CSCS)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:857 LILLIE HILL RD
Mailing Address - Street 2:
Mailing Address - City:APALACHIN
Mailing Address - State:NY
Mailing Address - Zip Code:13732-3111
Mailing Address - Country:US
Mailing Address - Phone:607-222-2327
Mailing Address - Fax:
Practice Address - Street 1:200 MONTGOMERY HWY
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1842
Practice Address - Country:US
Practice Address - Phone:205-939-1557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-29
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH106792251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic