Individual
MR. GEORGE W TERRY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
934 SIESTA DR, RICHMOND, KY 40475-3406
(859) 753-5222
Mailing address
934 SIESTA DR, RICHMOND, KY 40475-3406
(859) 753-5222
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA283
KY
Other
Enumeration date
03/29/2016
Last updated
04/13/2016
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