Individual
MR. JODY DAVID BERRYHILL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
L.A.T.
Contact information
Practice address
1005 W FAIRMONT ST, LONGVIEW, TX 75604-3511
(903) 295-5140
(903) 759-0898
Mailing address
2904 RUIDOSA ST, LONGVIEW, TX 75605-1510
(903) 297-6109
(903) 759-0898
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AT1292
TX
Other
Enumeration date
03/27/2006
Last updated
07/08/2007
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