Provider Demographics
NPI:1013642859
Name:LINDE, TERRY
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:LINDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27300 MESQUITE AVE
Mailing Address - Street 2:
Mailing Address - City:WELLTON
Mailing Address - State:AZ
Mailing Address - Zip Code:85356-3632
Mailing Address - Country:US
Mailing Address - Phone:877-492-1957
Mailing Address - Fax:866-865-6960
Practice Address - Street 1:27300 MESQUITE AVE
Practice Address - Street 2:
Practice Address - City:WELLTON
Practice Address - State:AZ
Practice Address - Zip Code:85356-3632
Practice Address - Country:US
Practice Address - Phone:877-492-1957
Practice Address - Fax:866-865-6960
Is Sole Proprietor?:No
Enumeration Date:2022-07-17
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach