Provider Demographics
NPI:1124364328
Name:WHITFIELD, TERRI LYNNE (PTA)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:LYNNE
Last Name:WHITFIELD
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 1:801 MEADOWOOD ST
Mailing Address - Street 2:APARTMENT 232
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-2838
Mailing Address - Country:US
Mailing Address - Phone:336-285-5068
Mailing Address - Fax:336-285-5068
Practice Address - Street 1:801 MEADOWOOD ST
Practice Address - Street 2:APARTMENT 232
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-2838
Practice Address - Country:US
Practice Address - Phone:336-285-5068
Practice Address - Fax:336-285-5068
Is Sole Proprietor?:No
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA3405225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant