Provider Demographics
NPI:1366419061
Name:THOMAS III, JOHN RICHARD III (MSPT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:RICHARD
Last Name:THOMAS III
Suffix:III
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 KIRKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1022
Mailing Address - Country:US
Mailing Address - Phone:609-601-8671
Mailing Address - Fax:609-390-9587
Practice Address - Street 1:210 S SHORE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:MARMORA
Practice Address - State:NJ
Practice Address - Zip Code:08223-1200
Practice Address - Country:US
Practice Address - Phone:609-390-2400
Practice Address - Fax:609-390-9587
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA010767225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist