Provider Demographics
NPI:1891001236
Name:LAVALLEE, TERI (PT, DPT, ATRIC, ITPT)
Entity Type:Individual
Prefix:DR
First Name:TERI
Middle Name:
Last Name:LAVALLEE
Suffix:
Gender:F
Credentials:PT, DPT, ATRIC, ITPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1698 HIGHWAY 160 W STE 240
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8035
Mailing Address - Country:US
Mailing Address - Phone:516-661-3087
Mailing Address - Fax:
Practice Address - Street 1:1698 HIGHWAY 160 W STE 240
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-8035
Practice Address - Country:US
Practice Address - Phone:516-661-3087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist