Individual
TERRI LEE ALTIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
1931 E 540TH RD, PLEASANT HOPE, MO 65725-9184
(417) 267-2307
(417) 267-6712
Mailing address
1931 E 540TH RD, PLEASANT HOPE, MO 65725-9184
(417) 267-2307
(417) 267-6712
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
115884
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115884
MISSOURI PTA LICENSE
MO
Enumeration date
02/11/2011
Last updated
02/11/2011
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