Provider Demographics
NPI:1770822447
Name:STONEMAN, THOMAS GORDON II (MS, PT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:GORDON
Last Name:STONEMAN
Suffix:II
Gender:M
Credentials:MS, PT
Other - Prefix:
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Mailing Address - Street 1:400 S INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:VA
Mailing Address - Zip Code:24348-3972
Mailing Address - Country:US
Mailing Address - Phone:276-773-9447
Mailing Address - Fax:276-773-9447
Practice Address - Street 1:400 S INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:VA
Practice Address - Zip Code:24348-3972
Practice Address - Country:US
Practice Address - Phone:276-773-9447
Practice Address - Fax:276-773-9447
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004951225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist