| Doctor Name: | RUSSELL P TERI |
| NPI Number: | 1669589578 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT20842 |
| Business Practice Address: | 4700 N Congress Ave Ste 103 West Palm Beach, FL - 334073282 |
| Business Phone Number: | 5612553131 |
| Business Fax Number: | 5616224324 |
| Mailing Address: | 4700 N. Congress Ave, Ste 103 WEST PALM BEACH |
| State: | FL |
| Postal Code: | 33407 |
| Phone Number: | 5612553131 |
| Fax Number: | 5616224324 |
| NPI Enumeration Date: | 08/24/2006 |
| NPI Last Update Date: | 01/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | PT20842 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |