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General NPI Number Information
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NPI Number | 1053381814
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Entity Type | Individual
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Provider Name | TERRY FENTON WILLS PHARM D
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 251 E ANTIETAM ST
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City | HAGERSTOWN
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State | MD
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Zip | 21740-5724
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Country | US
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Telephone | 301-790-8643
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Fax |
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Provider Business Mailing Address
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Address Line | 12902 CATHEDRAL AVE
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City | HAGERSTOWN
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State | MD
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Zip | 21742-2905
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Country | US
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Telephone | 301-791-1764
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 07552
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License Number State | MD
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