| Doctor Name: | MS. JERRICA THOMAS |
| NPI Number: | 1083023675 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 5615 |
| Business Practice Address: | 7545 Airways Blvd Southaven, MS - 386715806 |
| Business Phone Number: | 9017593208 |
| Business Fax Number: | |
| Mailing Address: | 1400 S Germantown Rd, GERMANTOWN |
| State: | TN |
| Postal Code: | 381382205 |
| Phone Number: | 9017593180 |
| Fax Number: | |
| NPI Enumeration Date: | 08/07/2014 |
| NPI Last Update Date: | 08/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 5615 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |