Individual
TERRY LEE PUDWILL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTAL
Contact information
Practice address
11133 369TH AVE, LEOLA, SD 57456-6506
(605) 530-7308
Mailing address
11133 369TH AVE, LEOLA, SD 57456-6506
(605) 530-7308
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
09/25/2008
Last updated
09/25/2008
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