Individual
MARY JALENE TERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
799 S MAIN ST, LIMA, OH 45804-1519
(419) 229-2222
Mailing address
16813 TOWNSHIP ROAD 55, BELLE CENTER, OH 43310-9664
(937) 441-9484
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
392993
OH
Other
Enumeration date
09/30/2020
Last updated
09/30/2020
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