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General NPI Number Information
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NPI Number | 1467510834
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Entity Type | Individual
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Provider Name | CATHY DIANE TERRY CLMT
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | MUSCULAR THERAPY CLINIC 4868 S. 96TH ST.
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City | OMAHA
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State | NE
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Zip | 68127-2048
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Country | US
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Telephone | 402-331-0392
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Fax | 402-331-0183
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Provider Business Mailing Address
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Address Line | 4868 S 96TH ST
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City | OMAHA
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State | NE
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Zip | 68127-2048
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Country | US
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Telephone | 402-331-0392
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Fax | 402-331-0183
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 571
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License Number State | NE
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