Provider Demographics
NPI:1669773131
Name:STOUGH, TERRY J (ATC)
Entity type:Individual
Prefix:MS
First Name:TERRY
Middle Name:J
Last Name:STOUGH
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 126
Mailing Address - Street 2:928 2ND AVE
Mailing Address - City:FRIENDSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21531
Mailing Address - Country:US
Mailing Address - Phone:301-387-8750
Mailing Address - Fax:
Practice Address - Street 1:86 PRIDE PKWY
Practice Address - Street 2:
Practice Address - City:ACCIDENT
Practice Address - State:MD
Practice Address - Zip Code:21520-2006
Practice Address - Country:US
Practice Address - Phone:301-746-8668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer