| Doctor Name: | MR. TERRY LEROY GUPTILL |
| NPI Number: | 1841470515 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT,ATC |
| License Number: | PT1541 |
| Business Practice Address: | 1242 11th St Clarkston, WA - 994032815 |
| Business Phone Number: | 5097582523 |
| Business Fax Number: | 5092952952 |
| Mailing Address: | 1242 11 Street, CLARKSTON |
| State: | WA |
| Postal Code: | 994032490 |
| Phone Number: | 5097582523 |
| Fax Number: | 5092952952 |
| NPI Enumeration Date: | 11/09/2007 |
| NPI Last Update Date: | 11/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT1541 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| 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 |