Provider Demographics
NPI:1447408786
Name:TERRY, ANDREA LYN (DPT)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:LYN
Last Name:TERRY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7233 CHURCH RANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-4094
Mailing Address - Country:US
Mailing Address - Phone:303-925-4137
Mailing Address - Fax:303-925-4143
Practice Address - Street 1:7233 CHURCH RANCH BLVD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-4094
Practice Address - Country:US
Practice Address - Phone:303-925-4137
Practice Address - Fax:303-925-4143
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0010082225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000212959Medicaid