Provider Demographics
NPI:1316964083
Name:ROYSE, TERRIE LYNNE (PT)
Entity type:Individual
Prefix:
First Name:TERRIE
Middle Name:LYNNE
Last Name:ROYSE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 SCOTSMAN NORTH RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:KS
Mailing Address - Zip Code:66717-7503
Mailing Address - Country:US
Mailing Address - Phone:620-537-2121
Mailing Address - Fax:
Practice Address - Street 1:801 S FRY ST
Practice Address - Street 2:
Practice Address - City:YATES CENTER
Practice Address - State:KS
Practice Address - Zip Code:66783-1640
Practice Address - Country:US
Practice Address - Phone:620-625-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-00575225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist