Individual
TERRY W MENNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DR
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
Update your record
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