Provider Demographics
NPI:1023421815
Name:CARTWRIGHT, THOMAS CAMERON (ATC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:CAMERON
Last Name:CARTWRIGHT
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5309 COMMONWEALTH CENTRE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2633
Mailing Address - Country:US
Mailing Address - Phone:804-545-7560
Mailing Address - Fax:804-545-7569
Practice Address - Street 1:5309 COMMONWEALTH CENTRE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2633
Practice Address - Country:US
Practice Address - Phone:804-545-7560
Practice Address - Fax:804-545-7569
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAB121708507146N00000X
VA01260018372255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic