MEDICARE: TERRI TAUCHER PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant		MI

General Provider Information

NPI Number	:	1174723316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI TAUCHER PTA

Provider Business Mailing Address
First Line	:	3425 EXECUTIVE PKWY
Second Line	:	SUITE 128
City	:	TOLEDO
State	:	OH
Zip	:	43606-1326
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6543 MIDDLEBELT RD
Second Line	:
City	:	GARDEN CITY
State	:	MI
Zip	:	48135-2145
Country	:	US
Telephone Number	:	734-458-7878
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2007
Last Update Date	:	07/24/2007

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Directions to “ TERRI TAUCHER PTA” Practice Location

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