Individual
JEFF TERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14505 W GRAND AVE, SURPRISE, AZ 85374-4358
(623) 975-4030
Mailing address
15164 N 140TH DR APT 1193, SURPRISE, AZ 85379-8574
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14980
AZ
Other
Enumeration date
11/01/2010
Last updated
11/01/2010
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