Provider Demographics
NPI:1679992879
Name:TERPENING, AMMON
Entity type:Individual
Prefix:
First Name:AMMON
Middle Name:
Last Name:TERPENING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1782 WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408-7014
Mailing Address - Country:US
Mailing Address - Phone:775-629-6009
Mailing Address - Fax:
Practice Address - Street 1:1782 WALNUT DR
Practice Address - Street 2:
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-7014
Practice Address - Country:US
Practice Address - Phone:775-629-6009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner