Provider Demographics
NPI:1790934065
Name:TERRY, JOEL ERRON (DC)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ERRON
Last Name:TERRY
Suffix:
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 1:12402 W 62ND TER
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-1810
Mailing Address - Country:US
Mailing Address - Phone:913-766-9266
Mailing Address - Fax:913-766-9265
Practice Address - Street 1:12402 W 62ND TER
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66216-1810
Practice Address - Country:US
Practice Address - Phone:913-766-9266
Practice Address - Fax:913-766-9265
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor