Provider Demographics
NPI:1982128229
Name:TERRIAN, KATHRYN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:TERRIAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 OCEAN AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32951-2568
Mailing Address - Country:US
Mailing Address - Phone:321-285-7572
Mailing Address - Fax:
Practice Address - Street 1:401 OCEAN AVE STE 204
Practice Address - Street 2:
Practice Address - City:MELBOURNE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32951-2568
Practice Address - Country:US
Practice Address - Phone:321-285-7572
Practice Address - Fax:321-222-5515
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.022983225100000X
FLPT35737225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist