Provider Demographics
NPI:1508912791
Name:SUTTON, THOMAS LEE (DPT, PT, CSCS,HFI)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LEE
Last Name:SUTTON
Suffix:
Gender:M
Credentials:DPT, PT, CSCS,HFI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-3168
Mailing Address - Country:US
Mailing Address - Phone:757-266-8886
Mailing Address - Fax:
Practice Address - Street 1:501 E 7TH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-3168
Practice Address - Country:US
Practice Address - Phone:757-266-8886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11759292251N0400X, 225100000X, 2251S0007X, 2251X0800X
CA29577225100000X, 2251N0400X, 2251S0007X, 2251X0800X
MD284322251X0800X, 2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic