Healthcare Provider Details

I. General information

NPI: 1689768004
Provider Name (Legal Business Name): TERRY D HUFFSTUTLER B.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERRY D MCQUEEN B.S.

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2409 HOMER CLAYTON DR
GUNTERSVILLE AL
35976-2207
US

IV. Provider business mailing address

56 DAVE COBB DR
CROSSVILLE AL
35962
US

V. Phone/Fax

Practice location:
  • Phone: 256-582-3203
  • Fax: 256-582-3216
Mailing address:
  • Phone: 256-894-8081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: