Provider Demographics
NPI:1639386378
Name:DUNNING, TERRE L
Entity Type:Individual
Prefix:MRS
First Name:TERRE
Middle Name:L
Last Name:DUNNING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TERRE
Other - Middle Name:L
Other - Last Name:BACHELDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 S 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:ILION
Mailing Address - State:NY
Mailing Address - Zip Code:13357-2012
Mailing Address - Country:US
Mailing Address - Phone:315-895-3048
Mailing Address - Fax:
Practice Address - Street 1:690 W GERMAN ST
Practice Address - Street 2:
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350-2135
Practice Address - Country:US
Practice Address - Phone:315-866-3330
Practice Address - Fax:315-866-6546
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist