Provider Demographics
NPI:1952442014
Name:TERRELL, JO L (PT)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:L
Last Name:TERRELL
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 1:481 N FREDERICK AVE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2480
Mailing Address - Country:US
Mailing Address - Phone:301-670-0466
Mailing Address - Fax:301-670-0774
Practice Address - Street 1:481 N FREDERICK AVE
Practice Address - Street 2:SUITE 405
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2480
Practice Address - Country:US
Practice Address - Phone:301-670-0466
Practice Address - Fax:301-670-0774
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15733225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist