Healthcare Provider Details

I. General information

NPI: 1609696863
Provider Name (Legal Business Name): TERRY HILL LC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2024
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

578 HARRELL ST
MEMPHIS TN
38112-2932
US

IV. Provider business mailing address

578 HARRELL ST
MEMPHIS TN
38112-2932
US

V. Phone/Fax

Practice location:
  • Phone: 901-907-0640
  • Fax: 901-255-0758
Mailing address:
  • Phone: 901-907-0640
  • Fax: 901-255-0758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: