Individual
TERRY W HENRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
503 W PINE ST, PHILIP, SD 57567-3300
(605) 859-2566
(605) 859-2948
Mailing address
503 W PINE ST, PO BOX 550, PHILIP, SD 57567-3300
(605) 859-2566
(605) 859-2948
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0581
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6827660
—
SD
Enumeration date
01/26/2006
Last updated
06/24/2008
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