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Individual

TERRY W MENNING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DR

Contact information

Practice address
215 1/2 N FIRST ST, GRANTS, NM 87020-2540
(505) 287-4833
Mailing address
215 1/2 N FIRST ST, GRANTS, NM 87020-2540
(505) 287-4833

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
202
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
155767181
BCBS
NM
01
201006763
PRES
NM
01
33580
DAVIS
NM
05
P8220
NM
Enumeration date
12/22/2006
Last updated
07/25/2013
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