Provider Demographics
NPI:1568649044
Name:KING, TERRY JOHN II (DC)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:JOHN
Last Name:KING
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 NORDIC WAY
Mailing Address - Street 2:
Mailing Address - City:SLINGER
Mailing Address - State:WI
Mailing Address - Zip Code:53086-9137
Mailing Address - Country:US
Mailing Address - Phone:262-309-8660
Mailing Address - Fax:
Practice Address - Street 1:111 NORDIC WAY
Practice Address - Street 2:
Practice Address - City:SLINGER
Practice Address - State:WI
Practice Address - Zip Code:53086-9137
Practice Address - Country:US
Practice Address - Phone:262-309-8660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-27
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4468-012111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition