Individual
TERI L GOURLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1025 CENTER ST, ASHLAND, OH 44805-4011
(419) 289-0491
Mailing address
75 REMIT DR, LOCKBOX 1056, CHICAGO, IL 60675-1056
(866) 916-5259
(231) 922-4030
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34-006332G
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2020860
—
OH
Enumeration date
07/17/2006
Last updated
02/20/2008
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