Provider Demographics
NPI:1376612705
Name:TERRY, APRIL LYNNE (ATC)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:LYNNE
Last Name:TERRY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1085
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MT
Mailing Address - Zip Code:59925-1085
Mailing Address - Country:US
Mailing Address - Phone:406-212-2322
Mailing Address - Fax:
Practice Address - Street 1:644 SIXTH AVENUE WEST
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1085
Practice Address - Country:US
Practice Address - Phone:406-212-2322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9706872255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
970687OtherATHLETIC TRAINER