National Provider Identifier

Terry Kevin Mattice, PTA

Terry Kevin Mattice, PTA is listed in the NPPES registry with a primary specialty of Physical Therapy Assistant in Ithaca, NY and a listed phone number of (607) 266-5316.

NPI 1790902880Ithaca, NYPhysical Therapy Assistant

Profile Overview

NPI
1790902880
Provider Type
Individual
Primary Specialty
Physical Therapy Assistant
Enumeration Date
April 19, 2007
Last Updated
July 08, 2007

Practice Location

  • 2230 N Triphammer RD
  • Ithaca, NY 14850-6513

Phone: (607) 266-5316

Mailing Address

  • 136 Pine Tree RD
  • Ithaca, NY 14850-6332

Specialties

  • Physical Therapy Assistant (225200000X)
Full Record
NPI
1790902880
Entity Type
Individual
Last Name
Mattice
First Name
Terry
Middle Name
Kevin
Credential
PTA
Mailing Street Address
136 Pine Tree RD
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850-6332
Mailing Country
US
Mailing Phone
(607) 272-9789
Practice Street Address
2230 N Triphammer RD
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-6513
Practice Country
US
Practice Phone
(607) 266-5316
Practice Fax
(607) 266-5353
Enumeration Date
April 19, 2007
Last Updated
July 08, 2007
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physical Therapy Assistant (225200000X)