Provider Demographics
NPI:1841517364
Name:KAHN, TERRY G (PT, DPT)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:G
Last Name:KAHN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:G
Other - Last Name:KAHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CMT
Mailing Address - Street 1:6191 RAN LYNN DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-5412
Mailing Address - Country:US
Mailing Address - Phone:540-725-1177
Mailing Address - Fax:
Practice Address - Street 1:4430 OLD CAVE SPRING RD
Practice Address - Street 2:SUITE B
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3421
Practice Address - Country:US
Practice Address - Phone:540-725-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019004887225700000X
VA2305209537225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist