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Organization

TIERRA LAKES MEDICAL GROUP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JANNIFER TERRY RN (OWNER)
(316) 440-4820
Entity
Organization

Contact information

Practice address
4969 N TIERRA LAKES PKWY, BEL AIRE, KS 67226-3345
(316) 440-4820
(316) 440-4851
Mailing address
4969 N TIERRA LAKES PKWY, BEL AIRE, KS 67226-3345
(316) 440-4820
(316) 440-4851

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
09/28/2016
Last updated
09/28/2016
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