Provider Demographics
NPI:1881927630
Name:ZELLER, THOMAS S (PT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:S
Last Name:ZELLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5315 MALIBU CT
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-5970
Mailing Address - Country:US
Mailing Address - Phone:239-471-7699
Mailing Address - Fax:239-432-9727
Practice Address - Street 1:6314 WHISKEY CREEK DR
Practice Address - Street 2:SUITE D
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919
Practice Address - Country:US
Practice Address - Phone:239-432-0556
Practice Address - Fax:239-432-9727
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT14620225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist