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Individual

MS. TERA MARIE QUIGLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D.

Contact information

Practice address
200 S JORDAN AVE, BLOOMINGTON, IN 47405-7002
(812) 856-1186
Mailing address
200 S JORDAN AVE, BLOOMINGTON, IN 47405-7002
(812) 856-1186

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002523A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100276980A
IN
Enumeration date
04/29/2013
Last updated
04/29/2013
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