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Organization

LYLA TERRY SALON

Active
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Organization

LYLA TERRY SALON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SCHQUANDA TERRY (SPECIALIST)
(904) 487-8468
Entity
Organization

Contact information

Practice address
12559 FALLOHIDE LN, JACKSONVILLE, FL 32225-3457
(904) 487-8468
Mailing address
12559 FALLOHIDE LN, JACKSONVILLE, FL 32225-3457
(904) 487-8468

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
NULL
1744P3200X
Prosthetics Case Management
Primary
—
—

Other

Enumeration date
03/29/2018
Last updated
03/29/2018
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