Provider Demographics
NPI:1811265341
Name:TERWILLIGER, TERRA ANN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:TERRA
Middle Name:ANN
Last Name:TERWILLIGER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:TERRA
Other - Middle Name:A
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:MAYO BUILDING
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:612-273-5550
Mailing Address - Fax:
Practice Address - Street 1:420 DELAWARE ST SE
Practice Address - Street 2:MAYO BUILDING
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0341
Practice Address - Country:US
Practice Address - Phone:612-273-5550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9267225100000X
NY033958225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist