Individual
TABITHA TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1851 LAKESIDE DR, MADISON, OH 44057-2171
(810) 441-7974
Mailing address
1851 LAKESIDE DR, MADISON, OH 44057-2171
(810) 441-7974
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA013711
OH
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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