Basic Information
| Provider Information | |||||||||
| NPI: | 1003016239 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABBOTT | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | OT, CHT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8826 LAKE VIEW DR | ||||||||
| Address2: | |||||||||
| City: | FAIRHOPE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 365326939 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514087779 | ||||||||
| FaxNumber: | 2514087779 | ||||||||
| Practice Location | |||||||||
| Address1: | 22873 US HWY 98 | ||||||||
| Address2: | BUILDING I SUITE 5 | ||||||||
| City: | MONTROSE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514087779 | ||||||||
| FaxNumber: | 2514087779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2007 | ||||||||
| LastUpdateDate: | 04/29/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT1265 | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.