Individual
TERRY L. BREITUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
316 S SAGE AVE, STE. B, MOBILE, AL 36606-3616
(251) 470-7772
(251) 470-7773
Mailing address
316 S SAGE AVE, STE. B, MOBILE, AL 36606-3616
(251) 470-7772
(251) 470-7773
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0414
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51079428
BCBS
AL
01
—
L172
MEDICARE GROUP
AL
Enumeration date
05/20/2006
Last updated
07/26/2010
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