Woodly Terry Dominique is a student in an organized health care education training program in Moultrie, GA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Woodly Terry Dominique NPI is 1457081507. The provider is registered as an individual entity type and is a single specialty group.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
2050 TALLOKAS RD
MOULTRIE, GA
ZIP 31768-666
Phone: (615) 935-8357
The NPI 1457081507 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 6/13/2022 and was last updated on 6/13/2022.