Individual
TERRY D SOUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3613 BRASELTON HWY, SUITE 101, DACULA, GA 30019-4665
(678) 482-2014
(678) 482-2997
Mailing address
3613 BRASELTON HWY, SUITE 101, DACULA, GA 30019-4665
(678) 482-2014
(678) 482-2997
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
02477
GA
Other
Enumeration date
09/26/2006
Last updated
07/08/2007
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