Provider Demographics
NPI:1962611681
Name:EMBRY, TERRI LYNN (ATC, CSCS, PTA)
Entity type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:LYNN
Last Name:EMBRY
Suffix:
Gender:F
Credentials:ATC, CSCS, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 BEVERLY DR
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:TN
Mailing Address - Zip Code:38004-7779
Mailing Address - Country:US
Mailing Address - Phone:901-837-9779
Mailing Address - Fax:901-475-9296
Practice Address - Street 1:108 BEVERLY DR
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:TN
Practice Address - Zip Code:38004-7779
Practice Address - Country:US
Practice Address - Phone:901-619-8657
Practice Address - Fax:901-475-9296
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAT00000008362255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer