Individual
GWENETH SUSAN TERRY-BALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
612 E JACKSON ST, HUGO, OK 74743-4025
(580) 326-2200
(580) 326-2201
Mailing address
612 E JACKSON ST, HUGO, OK 74743-4025
(580) 326-2000
(589) 326-2201
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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