Individual
TERRY L. PANGBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 S ELM ST, MOULTON, IA 52572-1441
(641) 856-7734
Mailing address
109 S ELM ST, MOULTON, IA 52572-1441
(641) 856-7734
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
022AA0001
IA
Other
Enumeration date
03/13/2008
Last updated
03/13/2008
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