Provider Demographics
NPI:1013433390
Name:THOMAS, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 N RACE ST
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-3473
Mailing Address - Country:US
Mailing Address - Phone:270-651-7882
Mailing Address - Fax:270-651-7883
Practice Address - Street 1:1410 N RACE ST
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-3473
Practice Address - Country:US
Practice Address - Phone:270-651-7882
Practice Address - Fax:270-651-7883
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN446631Medicaid