Provider Demographics
NPI:1356981153
Name:SWEET, TERRANCE EDWARD (RN, LMT)
Entity type:Individual
Prefix:
First Name:TERRANCE
Middle Name:EDWARD
Last Name:SWEET
Suffix:
Gender:M
Credentials:RN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2916 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-3614
Mailing Address - Country:US
Mailing Address - Phone:724-888-3138
Mailing Address - Fax:
Practice Address - Street 1:455 3RD ST FL 2
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2266
Practice Address - Country:US
Practice Address - Phone:724-774-8729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG013323225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist