Individual
KELLY DURWARD TERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
55 N 600 E, PRICE, UT 84501-2624
(435) 637-4621
(435) 637-5339
Mailing address
55 NORTH 600 EAST, PRICE, UT 84501
(435) 637-4621
(435) 637-5339
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
359704-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46643
ALTIUS THRU CHP
UT
01
—
50915
PEHP FOR CHP
UT
05
—
870395551019
—
UT
01
—
870395551TE5
EDUCATORS MUTUAL
UT
Enumeration date
08/13/2006
Last updated
03/12/2013
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