Provider Demographics
NPI:1205982212
Name:REDING, THOMAS ARTHUR (PT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:ARTHUR
Last Name:REDING
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 1:16 S ELKJER CIR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-4338
Mailing Address - Country:US
Mailing Address - Phone:605-334-2462
Mailing Address - Fax:605-334-0443
Practice Address - Street 1:16 S ELKJER CIR
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-4338
Practice Address - Country:US
Practice Address - Phone:605-334-2462
Practice Address - Fax:605-334-0443
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD55225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist