Provider Demographics
NPI:1720846553
Name:O'NEILL, TERRENCE MILES (PTA)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:MILES
Last Name:O'NEILL
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:SHARPSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16150-1903
Mailing Address - Country:US
Mailing Address - Phone:724-813-8171
Mailing Address - Fax:
Practice Address - Street 1:369 N HIGH ST
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:OH
Practice Address - Zip Code:44410-1022
Practice Address - Country:US
Practice Address - Phone:330-638-4015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant