Kelly Durward Terry, D.C.
Individual provider Active NPI Chiropractor · Price, UT
NPI 1255343752 · NPPES record last updated Mar 12, 2013
Key facts
- NPI
- 1255343752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 359704-1202 (UT)
- Practice address
- 55 N 600 E
Price, UT 84501-2624 - Phone
- (435) 637-4621
- Fax
- (435) 637-5339
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 359704-1202 | UT | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 359704-1202 | UT | Yes |
Addresses
Primary practice location
55 N 600 E
Price, UT 84501-2624
Mailing address
55 North 600 East
Price, UT 84501
Phone (435) 637-4621
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 46643 | Other | UT | ALTIUS THRU CHP |
| 870395551TE5 | Other | UT | EDUCATORS MUTUAL |
| 870395551019 | Medicaid | UT | |
| 50915 | Other | UT | PEHP FOR CHP |
Other providers in Price, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.