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Individual
MR. TERRY JOHN WHIELDON
Active
Individual
MR. TERRY JOHN WHIELDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
79921
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00011189901
UNIVERA
—
01
—
506103111
BLUE CROSS OF NY
—
01
—
9352186
INDEPENDENT HEALTH
—
Enumeration date
06/18/2008
Last updated
06/18/2008
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