Provider Demographics
NPI:1417178856
Name:TERRY, WILLIAM P (PT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:TERRY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:TERRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:101 E PINES RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-1021
Mailing Address - Country:US
Mailing Address - Phone:207-350-9973
Mailing Address - Fax:
Practice Address - Street 1:3039 OKATIE HWY
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29909-5101
Practice Address - Country:US
Practice Address - Phone:843-705-8224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2014-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY001975225100000X
SC16712251G0304X
GAPT0109692251G0304X
TX1177900314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics