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General NPI Number Information
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NPI Number | 1700862950
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Entity Type | Individual
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Provider Name | TERRY L JOLLIFF MPT
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Gender | Male
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 04/22/2010
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Provider Practice Location Address
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Address Line | 1069 KLOTZ RD
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City | BOWLING GREEN
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State | OH
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Zip | 43402-4820
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Country | US
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Telephone | 419-728-7019
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Fax | 419-728-7020
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Provider Business Mailing Address
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Address Line | 1725 WESTERN AVE SUITE B
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City | FINDLAY
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State | OH
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Zip | 45840-1345
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Country | US
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Telephone | 419-422-5526
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Fax | 419-422-5562
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT10483
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License Number State | OH
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