Provider Demographics
NPI:1336905090
Name:THOMAS, EMMA BROOKS (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:BROOKS
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 NUNN DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:KY
Mailing Address - Zip Code:41099-0002
Mailing Address - Country:US
Mailing Address - Phone:270-438-8436
Mailing Address - Fax:859-572-1565
Practice Address - Street 1:1 NUNN DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:KY
Practice Address - Zip Code:41099-0002
Practice Address - Country:US
Practice Address - Phone:270-438-8436
Practice Address - Fax:859-572-1565
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT21282255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer