Provider Demographics
NPI:1346851581
Name:TEROSKY, TAMMY LYNN (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:TEROSKY
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 WINESAP DR
Mailing Address - Street 2:
Mailing Address - City:PORT MATILDA
Mailing Address - State:PA
Mailing Address - Zip Code:16870-8300
Mailing Address - Country:US
Mailing Address - Phone:814-883-1233
Mailing Address - Fax:
Practice Address - Street 1:2134 SANDY DRIVE
Practice Address - Street 2:SUITE 6
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803
Practice Address - Country:US
Practice Address - Phone:814-883-1233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG013083225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist