Provider Demographics
NPI:1558442483
Name:TERRY, ERIN MARIE (MS, AT,C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:TERRY
Suffix:
Gender:F
Credentials:MS, AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 SMITHSON AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16511-2073
Mailing Address - Country:US
Mailing Address - Phone:814-899-1030
Mailing Address - Fax:
Practice Address - Street 1:300 STATE ST
Practice Address - Street 2:SUITE 106
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1427
Practice Address - Country:US
Practice Address - Phone:814-877-6195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0031412255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer