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Individual

TERRI LANDRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
250 N PARKWAY, STE 4, JACKSON, TN 38305-2735
(731) 668-1372
Mailing address
PO BOX 51266, NEW ORLEANS, LA 70151-1266

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0447284
TN
Enumeration date
08/06/2014
Last updated
08/06/2014
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