| Doctor Name: | MRS. TERRI LAKE BERKSHIRE |
| NPI Number: | 1326093279 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS PT |
| License Number: | 2305203594 |
| Business Practice Address: | 1500 Museum Road Suite 104 Conway Therapy Services Conway, AR - 72032 |
| Business Phone Number: | 5013293804 |
| Business Fax Number: | 8013290718 |
| Mailing Address: | 1500 Museum Road Suite 104, Conway Therapy Services CONWAY |
| State: | AR |
| Postal Code: | 72032 |
| Phone Number: | 5013293804 |
| Fax Number: | 8013290718 |
| NPI Enumeration Date: | 05/22/2006 |
| NPI Last Update Date: | 05/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2305203594 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |