Provider Demographics
NPI:1992221071
Name:TERRELL, CHRISTOPHER ADAM (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ADAM
Last Name:TERRELL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 RIVER SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-6566
Mailing Address - Country:US
Mailing Address - Phone:864-380-3341
Mailing Address - Fax:
Practice Address - Street 1:425 RIVER SUMMIT DR
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-6566
Practice Address - Country:US
Practice Address - Phone:864-380-3341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4862225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist