Provider Demographics
NPI:1700597721
Name:MOTLEY, TERRANCE COLE (DPT, PT, MS, CSCS)
Entity Type:Individual
Prefix:DR
First Name:TERRANCE
Middle Name:COLE
Last Name:MOTLEY
Suffix:
Gender:M
Credentials:DPT, PT, MS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:882 E 1040 S
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-5079
Mailing Address - Country:US
Mailing Address - Phone:505-610-2441
Mailing Address - Fax:
Practice Address - Street 1:98 N 1100 E STE 402
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2951
Practice Address - Country:US
Practice Address - Phone:505-610-2441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist