Provider Demographics
NPI:1275999567
Name:TERRY, CARA SHELDON (PT)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:SHELDON
Last Name:TERRY
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 1:160 N BLACK POWDER LN
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-7252
Mailing Address - Country:US
Mailing Address - Phone:512-656-0673
Mailing Address - Fax:
Practice Address - Street 1:160 N BLACK POWDER LN
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-7252
Practice Address - Country:US
Practice Address - Phone:512-656-0673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01596225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist