Provider Demographics
NPI:1164695169
Name:HUMMEL, TERRI LEE (PT)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:LEE
Last Name:HUMMEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:LEE
Other - Last Name:WENDTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:101 PLAZA CARMONA PL
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOT SPRINGS VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71909-3000
Mailing Address - Country:US
Mailing Address - Phone:501-922-1686
Mailing Address - Fax:501-922-9735
Practice Address - Street 1:101 PLAZA CARMONA PL
Practice Address - Street 2:SUITE B
Practice Address - City:HOT SPRINGS VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71909-3000
Practice Address - Country:US
Practice Address - Phone:501-922-1686
Practice Address - Fax:501-922-9735
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3158225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist