MEDICARE: TERRY G. KAHN PT, DPT

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	225700000X	Massage Therapist	0019004887	VA
2	225100000X	Physical Therapist	2305209537	VA

General Provider Information

NPI Number	:	1841517364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRY G. KAHN PT, DPT

Provider Business Mailing Address
First Line	:	6191 RAN LYNN DR
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-5412
Country	:	US
Telephone Number	:	540-725-1177
Fax Number	:

Provider Business Practice Location Address
First Line	:	4430 OLD CAVE SPRING RD
Second Line	:	SUITE B
City	:	ROANOKE
State	:	VA
Zip	:	24018-3421
Country	:	US
Telephone Number	:	540-725-1177
Fax Number	:

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

Provider Enumeration Date	:	04/23/2010
Last Update Date	:	12/01/2016

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