Provider Demographics
NPI:1154593812
Name:HOLDER-RYDER, TERRY JON (DPT)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:JON
Last Name:HOLDER-RYDER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 SEVEN FARMS DR STE C-249
Mailing Address - Street 2:
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-8001
Mailing Address - Country:US
Mailing Address - Phone:843-732-1732
Mailing Address - Fax:
Practice Address - Street 1:295 SEVEN FARMS DR STE C-249
Practice Address - Street 2:
Practice Address - City:DANIEL ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29492-8001
Practice Address - Country:US
Practice Address - Phone:843-732-1732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100322251N0400X
SC67682251E1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology