Doctor Name: | MR. THOMAS STEVEN PORTNER |
NPI Number: | 1861602617 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | |
Business Practice Address: | 200 N Emerald Ln 1a Carbondale, IL - 629012100 |
Business Phone Number: | 6185499449 |
Business Fax Number: | 6185498827 |
Mailing Address: | 16864 E Il Highway 15, MOUNT VERNON |
State: | IL |
Postal Code: | 628649816 |
Phone Number: | 6182423739 |
Fax Number: | 6182425567 |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |