Provider Demographics
NPI:1992990030
Name:GUIDO, TERRI A (PT)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:A
Last Name:GUIDO
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 1:5989 E GRANT RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2336
Mailing Address - Country:US
Mailing Address - Phone:520-722-5477
Mailing Address - Fax:520-886-5358
Practice Address - Street 1:5989 E GRANT RD
Practice Address - Street 2:SUITE 102
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2336
Practice Address - Country:US
Practice Address - Phone:520-722-5477
Practice Address - Fax:520-886-5358
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ506225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ0000BGMZCMedicare PIN