Individual
TERRY JOE CARLYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
903 S OAK AVE, OWATONNA, MN 55060-3200
(507) 455-7631
Mailing address
1435 CLOVER LANE SE, OWATONNA, MN 55060
(507) 451-1924
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
1059
MN
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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