Individual
SHAWN DWAYNE TERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COMMERCIAL DRIVER
Contact information
Practice address
5120 BROERMAN AVE APT B4, CINCINNATI, OH 45217-1136
(513) 687-3940
Mailing address
5120 BROERMAN AVE APT B4, CINCINNATI, OH 45217-1136
(513) 687-3940
Taxonomy
Speciality
Code
Description
License number
State
171WV0202X
Vehicle Modifications Contractor
Primary
RN915945
OH
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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