Provider Demographics
NPI:1194305169
Name:TERRAN, JAMIE MARIE (DPT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:MARIE
Last Name:TERRAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9740 W CAROL AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-6367
Mailing Address - Country:US
Mailing Address - Phone:602-810-9653
Mailing Address - Fax:
Practice Address - Street 1:10503 W THUNDERBIRD BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-2746
Practice Address - Country:US
Practice Address - Phone:623-888-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP018894T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist