Provider Demographics
NPI:1356325682
Name:DANA TERRY PC
Entity Type:Organization
Organization Name:DANA TERRY PC
Other - Org Name:MOTIONWORKS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:405-224-9675
Mailing Address - Street 1:3410 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73018-7502
Mailing Address - Country:US
Mailing Address - Phone:405-224-9675
Mailing Address - Fax:405-224-9677
Practice Address - Street 1:3410 S 4TH ST
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-7502
Practice Address - Country:US
Practice Address - Phone:405-224-9675
Practice Address - Fax:405-224-9677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
900522046Medicare ID - Type Unspecified