Individual
DR. JACK E TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D., PH.D.
Contact information
Practice address
200 S COLLEGE ST, CHARLOTTE, NC 28202-2012
(704) 887-0824
(704) 332-9568
Mailing address
200 S COLLEGE ST, CHARLOTTE, NC 28202-2012
(704) 887-0824
(704) 332-9568
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1469
NC
152W00000X
Optometrist
5608
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057645
OE TRACKER
NC
Enumeration date
08/10/2016
Last updated
08/10/2016
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