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NPI Code Detail

MEDICARE: DR. TERRY LEE GLOE DC

MEDICARE:  DR. TERRY LEE GLOE  DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor627SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
121990OTHERSDSIOUX VALLY HEALTH PLAN
20080125OTHERSDWELLMARK BCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356396741
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERRY LEE GLOE DC
Provider Business Mailing Address
First Line : 726 E 6TH ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57103-1302
Country : US
Telephone Number : 605-338-0772
Fax Number : 605-338-0772
Provider Business Practice Location Address
First Line : 726 E 6TH ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57103-1302
Country : US
Telephone Number : 605-338-0772
Fax Number : 605-338-0772
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 07/08/2007

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Directions to “ DR. TERRY LEE GLOE DC” Practice Location

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