Individual
DANIEL W. TERRY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1121 W VINE STREET, SUITE 15, LODI, CA 95240
(209) 334-4416
(209) 371-0119
Mailing address
PO BOX 15498, SACRAMENTO, CA 95851
(559) 455-4000
(559) 455-4007
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G28938
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G289380
—
CA
Enumeration date
08/02/2006
Last updated
12/12/2007
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