Individual
MR. TERENCE ALAN DUNAVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1506 PENDLETON RD, AUGUSTA, GA 30904-4840
(706) 726-5663
Mailing address
1506 PENDLETON RD, AUGUSTA, GA 30904-4840
(706) 726-5663
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
43932
SC
164W00000X
Licensed Practical Nurse
Primary
LPN073147
GA
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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