Individual
TERRY WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
412 E MAIN ST, NEW LONDON, IA 52645-1220
(641) 572-0065
Mailing address
412 E MAIN ST, NEW LONDON, IA 52645-1220
(641) 572-0065
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A114616
IA
Other
Enumeration date
03/22/2018
Last updated
03/22/2018
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