Provider Demographics
NPI:1396804381
Name:THOMAS, AMY LOUISE (ATC, CSCS)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LOUISE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:362 WEDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-2053
Mailing Address - Country:US
Mailing Address - Phone:302-369-2783
Mailing Address - Fax:
Practice Address - Street 1:4701 LIMESTONE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1927
Practice Address - Country:US
Practice Address - Phone:302-225-6217
Practice Address - Fax:302-998-6823
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE9713372255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer