Thomas Wayne Holton, M.S.S. A.T.,C
Specialist/Technologist, Athletic Trainer in Willimantic, CT. Individual provider (NPI-1).
NPI number1154420164
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1154420164
- Entity type
- Individual (NPI-1)
- Name
- Mr. Thomas Wayne Holton
- Credential
- M.S.S. A.T.,C
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 22, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 255A2300X | CT | Yes |
Practice location
83 Windham StWillimantic, CT 06226-2211
Phone 860-465-5171 · Fax 860-465-4696
Mailing address
77 Deer Run RdWindham, CT 06280-1535
Phone 860-450-0893
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