Doctor Name: | CLAY KIMBALL THOMAS |
NPI Number: | 1396932570 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | PT005367 |
Business Practice Address: | 735 Hummingbird Ct Clarkesville, GA - 305235198 |
Business Phone Number: | 7097544379 |
Business Fax Number: | |
Mailing Address: | 735 Hummingbird Ct, CLARKESVILLE |
State: | GA |
Postal Code: | 305235198 |
Phone Number: | 7097544379 |
Fax Number: | |
NPI Enumeration Date: | 10/01/2007 |
NPI Last Update Date: | 10/01/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | PT005367 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |