Provider Demographics
NPI:1427341189
Name:TERVO, REBECCA MARIE (DPT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIE
Last Name:TERVO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:MARIE
Other - Last Name:AALTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:39 CINEMA BLVD
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-3290
Mailing Address - Country:US
Mailing Address - Phone:978-466-6677
Mailing Address - Fax:978-466-1133
Practice Address - Street 1:39 CINEMA BLVD
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3290
Practice Address - Country:US
Practice Address - Phone:978-466-6677
Practice Address - Fax:978-466-1133
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19495225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist