Individual
DR. RICHARD N TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1284 N SUMMIT AVE, OCONOMOWOC, WI 53066-4459
(262) 560-3700
(262) 569-2206
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(262) 560-3700
(262) 569-2206
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
56872-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100030502
—
WI
05
—
1124342738
—
WI
Enumeration date
03/25/2010
Last updated
07/24/2023
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