Dominique, Woodly Terry

Dominique, Woodly Terry is an sole proprietor health care provider with primary practice located at 2050 Tallokas Rd , Moultrie GA 31768-7666. He recently has only one registered license in Student, Health Care / Student in an Organized Health Care Education/Training Program, which is considered as his primary health care specialty. Dominique, Woodly Terry can be contacted via phone (615) 935-8357.

Contact Information

Primary practice address
2050 Tallokas Rd Moultrie GA 31768-7666
Phone: (615) 935-8357
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1457081507
LBN Legal business name Dominique, Woodly Terry
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 13th, 2022
Last updated Jun 13th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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