Provider Demographics
NPI:1366080137
Name:TERRY, ERIN ROSE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ROSE
Last Name:TERRY
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 1:1684 STATE ROUTE 13
Mailing Address - Street 2:
Mailing Address - City:CAYUTA
Mailing Address - State:NY
Mailing Address - Zip Code:14824-9630
Mailing Address - Country:US
Mailing Address - Phone:607-857-8499
Mailing Address - Fax:
Practice Address - Street 1:634 MAIN ST
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-3034
Practice Address - Country:US
Practice Address - Phone:307-332-2715
Practice Address - Fax:307-332-0314
Is Sole Proprietor?:No
Enumeration Date:2019-12-12
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0016684225100000X
NY043459225100000X
WYPT-1933225100000X
CT12092225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist