Organization
TERRY LIVELY ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY LIVELY (OWNER)
(210) 862-3087
Entity
Organization
Contact information
Practice address
1478 FM 2673, CANYON LAKE, TX 78133-4583
(210) 585-8410
Mailing address
7575 DR PHILLIPS BLVD STE 155, ORLANDO, FL 32819-7220
(407) 982-4876
(407) 650-2754
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
10/24/2023
Last updated
11/30/2023
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