Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 049502533 | GA |
Y | 213ES0000X | Sports Medicine | 049502533 | GA |
NPI | 1043985963 |
---|---|
Provider Name | Joyce L Terrell |
First Address | Atlanta, GA 30318-7145 |
Second Address | Atlanta, GA 30310-1812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2021 |
Last Update Date | 12/08/2021 |