Provider Demographics
NPI:1336328699
Name:JEANNE, TERRY (L AC)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:JEANNE
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 E 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-7900
Mailing Address - Country:US
Mailing Address - Phone:865-386-5181
Mailing Address - Fax:
Practice Address - Street 1:1932 ALCOA HWY
Practice Address - Street 2:UTIMIH BLDG C SUITE 470
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921
Practice Address - Country:US
Practice Address - Phone:423-400-3884
Practice Address - Fax:423-553-8590
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN110171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist