Provider Demographics
NPI:1578811360
Name:MENEFEE, TERRANCE A JR
Entity Type:Individual
Prefix:MR
First Name:TERRANCE
Middle Name:A
Last Name:MENEFEE
Suffix:JR
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 1:5247 WILSON MILLS RD
Mailing Address - Street 2:134
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3016
Mailing Address - Country:US
Mailing Address - Phone:757-619-0063
Mailing Address - Fax:888-426-7350
Practice Address - Street 1:5247 WILSON MILLS RD
Practice Address - Street 2:134
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-3016
Practice Address - Country:US
Practice Address - Phone:757-619-0063
Practice Address - Fax:888-426-7350
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRK689133111NX0800X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No111NX0800XChiropractic ProvidersChiropractorOrthopedic