Individual
ANNA LEE TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
165 PEPPERS FERRY RD, WYTHEVILLE, VA 24382-2070
(276) 223-5412
Mailing address
165 PEPPERS FERRY RD, WYTHEVILLE, VA 24382-2070
(276) 223-5412
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003917
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104562
NCCPA
—
Enumeration date
06/15/2012
Last updated
02/19/2021
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