Healthcare Provider Details

I. General information

NPI: 1417178856
Provider Name (Legal Business Name): WILLIAM P TERRY PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BILL TERRY PT

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 10/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3039 OKATIE HWY
BLUFFTON SC
29909-5101
US

IV. Provider business mailing address

101 E PINES RD
SAVANNAH GA
31410-1021
US

V. Phone/Fax

Practice location:
  • Phone: 843-705-8224
  • Fax:
Mailing address:
  • Phone: 207-350-9973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number001975
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number1671
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT010969
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: