Individual
IVAN TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4502 NORTH ST, NACOGDOCHES, TX 75965-1810
(936) 305-5321
Mailing address
5303 50TH ST, LUBBOCK, TX 79414-1817
(806) 474-6061
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
11909
TX
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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