Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist | TN |
NPI | 1104922681 |
---|---|
Provider Name | Terry Graybeal |
First Address | Greeneville, TN 37745-4287 |
Second Address | Fletcher, NC 28732-8241 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 04/12/2018 |