Provider Demographics
NPI:1053385427
Name:THOMAS, ROBERT E (MSPT, LATC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MSPT, LATC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:411 MASS AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3739
Mailing Address - Country:US
Mailing Address - Phone:978-263-0007
Mailing Address - Fax:978-263-0014
Practice Address - Street 1:411 MASS AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3739
Practice Address - Country:US
Practice Address - Phone:978-263-0007
Practice Address - Fax:978-263-0014
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA15629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist