Provider Demographics
NPI:1558507426
Name:TAYLOR, TERRIE LEE (LMT)
Entity Type:Individual
Prefix:MS
First Name:TERRIE
Middle Name:LEE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:TERRIE
Other - Middle Name:LEE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:223 MARBURGER RD
Mailing Address - Street 2:
Mailing Address - City:EVANS CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16033-7717
Mailing Address - Country:US
Mailing Address - Phone:724-991-8816
Mailing Address - Fax:
Practice Address - Street 1:223 MARBURGER RD
Practice Address - Street 2:
Practice Address - City:EVANS CITY
Practice Address - State:PA
Practice Address - Zip Code:16033-7717
Practice Address - Country:US
Practice Address - Phone:724-991-8816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-26
Last Update Date:2012-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist