Organization
TERRY WALSH, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRANCE WALSH O.D. (PRESIDENT)
(701) 433-7290
Entity
Organization
Contact information
Practice address
4831 13TH AVE S, FARGO, ND 58103-7206
(701) 433-7290
Mailing address
987 14TH AVE E, WEST FARGO, ND 58078-3311
(701) 281-7087
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01788002
BS OF ND
ND
05
—
60640
—
ND
Enumeration date
01/30/2007
Last updated
07/02/2008
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