Provider Demographics
NPI:1659807600
Name:TERKMAN, JAMILA LATIFA (DPT)
Entity Type:Individual
Prefix:
First Name:JAMILA
Middle Name:LATIFA
Last Name:TERKMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 GRACE ELLEN DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-1737
Mailing Address - Country:US
Mailing Address - Phone:573-825-2030
Mailing Address - Fax:
Practice Address - Street 1:2333 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-1568
Practice Address - Country:US
Practice Address - Phone:573-304-4514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015027148225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist