Provider Demographics
NPI:1750466462
Name:SPRAY, THOMAS K (PT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:K
Last Name:SPRAY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21300 N JOHN WAYNE PKWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-8979
Mailing Address - Country:US
Mailing Address - Phone:520-868-6100
Mailing Address - Fax:520-868-6106
Practice Address - Street 1:21300 N JOHN WAYNE PKWY
Practice Address - Street 2:SUITE 107
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85139-8979
Practice Address - Country:US
Practice Address - Phone:520-868-6100
Practice Address - Fax:520-868-6106
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6455225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist