Provider Demographics
NPI:1548686611
Name:AVERY, TERRY RUTH (PTA)
Entity type:Individual
Prefix:MRS
First Name:TERRY
Middle Name:RUTH
Last Name:AVERY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:TERRY
Other - Middle Name:RUTH
Other - Last Name:TWOMBLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:195 DOVER POINT RD.
Mailing Address - Street 2:ST. ANN (SAINT ANN HEALTHCARE CENTER)
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820
Mailing Address - Country:US
Mailing Address - Phone:603-742-2612
Mailing Address - Fax:603-743-3055
Practice Address - Street 1:195 DOVER POINT RD.
Practice Address - Street 2:ST. ANN HEALTHCARE CTR
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820
Practice Address - Country:US
Practice Address - Phone:603-742-2612
Practice Address - Fax:603-743-3055
Is Sole Proprietor?:No
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0007225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant