Provider Demographics
NPI:1144639295
Name:TERRY, CHRISTINA MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:TERRY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:CHRISTINA
Other - Middle Name:MARIE
Other - Last Name:SCHUKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4829 CAROLINA BEACH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2366
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4829 CAROLINA BEACH RD STE 100
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2366
Practice Address - Country:US
Practice Address - Phone:910-444-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-03
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14014225100000X
SCPT.7847 PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist