Provider Demographics
NPI:1114544939
Name:GIESE, TERA ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:TERA
Middle Name:ELIZABETH
Last Name:GIESE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 CHARLOTTE AVE APT 429
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-3895
Mailing Address - Country:US
Mailing Address - Phone:615-651-1441
Mailing Address - Fax:
Practice Address - Street 1:4510 CHARLOTTE AVE APT 429
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-3895
Practice Address - Country:US
Practice Address - Phone:615-651-1441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11341225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist