Organization
LYLA TERRY SALON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCHQUANDA TERRY (SPECIALIST)
(904) 487-8468
Entity
Organization
Contact information
Practice address
12559 FALLOHIDE LN, JACKSONVILLE, FL 32225-3457
(904) 487-8468
Mailing address
12559 FALLOHIDE LN, JACKSONVILLE, FL 32225-3457
(904) 487-8468
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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