Provider Demographics
NPI:1811200181
Name:MILLER, TERRI ANN (PT)
Entity type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:ANN
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14 ANNA AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLE SHADE
Mailing Address - State:NJ
Mailing Address - Zip Code:08052-3239
Mailing Address - Country:US
Mailing Address - Phone:856-667-5499
Mailing Address - Fax:
Practice Address - Street 1:101 BURRS RD
Practice Address - Street 2:SUITE G
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-5517
Practice Address - Country:US
Practice Address - Phone:609-261-4330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01357800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist