Individual
MR. TERRANCE DESMOND EPPENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HHA
Contact information
Practice address
906 HUEY ST, SOUTH BEND, IN 46628-2509
(574) 229-3318
Mailing address
906 HUEY ST, SOUTH BEND, IN 46628-2509
(574) 229-3318
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
HHA0800371
IN
Other
Enumeration date
11/03/2010
Last updated
11/03/2010
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