Provider Demographics
NPI:1073832275
Name:WEBBER, TERESA LYNN (PTA)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:LYNN
Last Name:WEBBER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34100 COUNTY ROAD 107
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MT
Mailing Address - Zip Code:59262-9464
Mailing Address - Country:US
Mailing Address - Phone:406-776-2477
Mailing Address - Fax:
Practice Address - Street 1:34100 COUNTY ROAD 107
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MT
Practice Address - Zip Code:59262-9464
Practice Address - Country:US
Practice Address - Phone:406-776-2477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1600225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant