Larry Edward Terrell CAC III

NPI 1124237730 - Specialist - 174400000X

NPI Details
NPI 1124237730
Gender Male
Enumeration Date 05/21/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1711 E EVANS AVE
PUEBLO CO, 81004-3349, US
Phone (719) 561-9850
Fax
Business Location
3470 BALTIMORE AVE
PUEBLO CO, 81008-1520, US
Phone (719) 545-1181
Fax (719) 545-4097
Toxanomy
Taxonomy Code 174400000X
License State Colorado
License Number 3164
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According to our database, Mr. Larry Edward Terrell CAC III NPI is 1124237730, taxonomy code is 174400000X and license number is 3164, license state is located at Colorado. Larry Edward Terrell CAC III physically located at 1711 E Evans Ave, Pueblo CO, 81004-3349. NPI Number Larry Edward Terrell CAC III has the Individual type.

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1124237730 NPI number is provided on an as is basis without warranty of any kind. 1124237730 is maintained by the National Plan & Provider Enumeration System. The contents of Larry Edward Terrell CAC III are for informational purposes only.