Doctor Name: | MR. THOMAS LAIR |
NPI Number: | 1497148795 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 15152 |
Business Practice Address: | 20 Medical Campus Dr Nw Suite 204 Supply, NC - 284624096 |
Business Phone Number: | 9107555861 |
Business Fax Number: | 9107555865 |
Mailing Address: | 20 Medical Campus Dr Nw, Suite 204 SUPPLY |
State: | NC |
Postal Code: | 284624096 |
Phone Number: | 9107555861 |
Fax Number: | 9107555865 |
NPI Enumeration Date: | 03/10/2015 |
NPI Last Update Date: | 03/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | 15152 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |