Provider Demographics
NPI:1699717686
Name:YOUNG, TERRY MOYER (PT)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:MOYER
Last Name:YOUNG
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 1:304 PAGE ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-2008
Mailing Address - Country:US
Mailing Address - Phone:910-944-1169
Mailing Address - Fax:
Practice Address - Street 1:200 N POPLAR ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NC
Practice Address - Zip Code:28315-2812
Practice Address - Country:US
Practice Address - Phone:910-944-1169
Practice Address - Fax:910-944-1566
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2409225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCB3032OtherMED COST
NC078CWOtherBLUE CROSS BLUE SHIELD NC
NCFH80000010OtherFIRST CAROLINA CARE
NCB3032OtherMED COST