Provider Demographics
NPI:1730874363
Name:THORNTON, JODI (PT, DPT)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:THORNTON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10415 STATE HIGHWAY 151 STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4553
Mailing Address - Country:US
Mailing Address - Phone:210-647-1167
Mailing Address - Fax:210-479-3338
Practice Address - Street 1:16530 HUEBNER RD STE 119
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-1699
Practice Address - Country:US
Practice Address - Phone:210-479-3334
Practice Address - Fax:210-479-3338
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1366211OtherTEXAS BOARD OF PHYSICAL THERAPY EXAMINERS