Provider Demographics
NPI:1801020045
Name:THOMAS, PULIANTHURUTHIL JOSEPH (NCTM)
Entity Type:Individual
Prefix:MR
First Name:PULIANTHURUTHIL
Middle Name:JOSEPH
Last Name:THOMAS
Suffix:
Gender:M
Credentials:NCTM
Other - Prefix:MR
Other - First Name:P
Other - Middle Name:J
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCTM
Mailing Address - Street 1:22548-RAMBLING DRIVE
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-3739
Mailing Address - Country:US
Mailing Address - Phone:586-468-0312
Mailing Address - Fax:586-468-0312
Practice Address - Street 1:22548-RAMBLING DRIVE
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-3739
Practice Address - Country:US
Practice Address - Phone:586-468-0312
Practice Address - Fax:586-468-0312
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist
No175F00000XOther Service ProvidersNaturopath