Provider Demographics
NPI:1972277093
Name:EWING AND THOMAS, INC
Entity Type:Organization
Organization Name:EWING AND THOMAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHANNES
Authorized Official - Middle Name:
Authorized Official - Last Name:WIJNAMAALEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:727-848-3962
Mailing Address - Street 1:5311 GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4014
Mailing Address - Country:US
Mailing Address - Phone:727-848-3962
Mailing Address - Fax:727-848-7028
Practice Address - Street 1:701 N. WESTSHORE BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609
Practice Address - Country:US
Practice Address - Phone:813-533-7070
Practice Address - Fax:727-848-7028
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EWING AND THOMAS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty