Provider Demographics
NPI:1760183362
Name:TOMPKINS, TERRA ELIZABETH (PT)
Entity Type:Individual
Prefix:MS
First Name:TERRA
Middle Name:ELIZABETH
Last Name:TOMPKINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3404 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:WV
Mailing Address - Zip Code:26105-2504
Mailing Address - Country:US
Mailing Address - Phone:304-210-5545
Mailing Address - Fax:
Practice Address - Street 1:606 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-2465
Practice Address - Country:US
Practice Address - Phone:740-423-5901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV002482225100000X
OHPT011728225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist