Provider Demographics
NPI:1609973726
Name:BEDFORD, TERRI LYNN (DPT,MTC)
Entity Type:Individual
Prefix:MS
First Name:TERRI
Middle Name:LYNN
Last Name:BEDFORD
Suffix:
Gender:F
Credentials:DPT,MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3937 PATIENT CARE WAY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-4287
Mailing Address - Country:US
Mailing Address - Phone:517-272-9320
Mailing Address - Fax:517-272-9321
Practice Address - Street 1:3937 PATIENT CARE WAY
Practice Address - Street 2:SUITE 105
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4287
Practice Address - Country:US
Practice Address - Phone:517-272-9320
Practice Address - Fax:517-272-9321
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008842225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist