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Individual

MR. TERRY L PULSFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
105 MCKNIGHT DRIVE, MIDDLETOWN, OH 45044-4898
(513) 424-2111
(513) 420-5662
Mailing address
PO BOX 640929, CINCINNATI, OH 45264-0929
(513) 727-0748

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN300913
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000324925
ANTHEM
OH
05
2376790
OH
01
8231273
MEDICARE
OH
Enumeration date
07/11/2006
Last updated
07/08/2007
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