Provider Demographics
NPI:1528023082
Name:PEARSON, TERRANCE R (PT)
Entity Type:Individual
Prefix:
First Name:TERRANCE
Middle Name:R
Last Name:PEARSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BROOKE LN
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-4488
Mailing Address - Country:US
Mailing Address - Phone:256-831-5881
Mailing Address - Fax:
Practice Address - Street 1:1617 LEIGHTON AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-3830
Practice Address - Country:US
Practice Address - Phone:256-237-7500
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3584225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-97597Medicare ID - Type UnspecifiedPROVIDER NUMBER