Provider Demographics
NPI:1669759171
Name:ROHDE, TERRI
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:ROHDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 53RD AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-4706
Mailing Address - Country:US
Mailing Address - Phone:941-228-2423
Mailing Address - Fax:941-751-5515
Practice Address - Street 1:308 53RD AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-4706
Practice Address - Country:US
Practice Address - Phone:941-228-2423
Practice Address - Fax:941-751-5515
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-11
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy Fitter