Provider Demographics
NPI:1740995604
Name:WEBSTER, NOAH THOMAS (LAT, ATC)
Entity type:Individual
Prefix:MR
First Name:NOAH
Middle Name:THOMAS
Last Name:WEBSTER
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7670 ARMIGER DR
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-4320
Mailing Address - Country:US
Mailing Address - Phone:302-258-7207
Mailing Address - Fax:
Practice Address - Street 1:200 CLEAVER FARMS RD STE 400
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1630
Practice Address - Country:US
Practice Address - Phone:713-297-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ3-00108982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer