Provider Demographics
NPI:1720226848
Name:ADAMSON, TERA MARIE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:TERA
Middle Name:MARIE
Last Name:ADAMSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TERA
Other - Middle Name:MARIE
Other - Last Name:RAYMONT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:265 ELM DRIVE
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-3437
Mailing Address - Country:US
Mailing Address - Phone:724-627-0685
Mailing Address - Fax:724-627-3712
Practice Address - Street 1:265 ELM DR
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-8275
Practice Address - Country:US
Practice Address - Phone:724-627-0685
Practice Address - Fax:724-627-3712
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019889174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist