Provider Demographics
NPI:1871577346
Name:CLEMENS, TERRY L (DC)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:L
Last Name:CLEMENS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 TOWER WAY
Mailing Address - Street 2:SUITE 2036
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5786
Mailing Address - Country:US
Mailing Address - Phone:724-600-7248
Mailing Address - Fax:724-600-7249
Practice Address - Street 1:2000 TOWER WAY
Practice Address - Street 2:SUITE 2036
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5786
Practice Address - Country:US
Practice Address - Phone:724-600-7248
Practice Address - Fax:724-600-7249
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007575L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU77904Medicare UPIN
PA033783Medicare ID - Type Unspecified