Individual
TOMMIE TERRELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPA
Contact information
Practice address
2110 CHATHAM DR, ALBANY, GA 31721-2112
(229) 809-7878
(229) 496-1610
Mailing address
2110 CHATHAM DR, ALBANY, GA 31721-2112
(229) 809-7878
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
17074583
GA
Other
Enumeration date
07/14/2017
Last updated
07/14/2017
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