Healthcare Provider Details

I. General information

NPI: 1205924453
Provider Name (Legal Business Name): TERRI CHERNI P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 04/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

1088 CONN DR
EVANS GA
30809-4860
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-2482
  • Fax:
Mailing address:
  • Phone: 706-830-6779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5128
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT008841
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: