Individual
TERRY J. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 SHC DRIVE BYUI, REXBURG, ID 83460-2010
(208) 496-9330
(208) 496-9333
Mailing address
100 SHC DRIVE BYUI, REXBURG, ID 83460-2010
(208) 496-9330
(208) 496-9333
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 663
ID
Other
Enumeration date
07/03/2006
Last updated
04/05/2013
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