Provider Demographics
NPI:1891084687
Name:CARR, TERI J (PT)
Entity Type:Individual
Prefix:MRS
First Name:TERI
Middle Name:J
Last Name:CARR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:489 STATE ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6616
Mailing Address - Country:US
Mailing Address - Phone:207-973-7000
Mailing Address - Fax:207-973-5042
Practice Address - Street 1:43 WHITING HILL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1005
Practice Address - Country:US
Practice Address - Phone:207-973-5035
Practice Address - Fax:207-973-5042
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT668225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist