person
Woodly Terry Dominique
Student in an Organized Health Care Education/Training Program in Moultrie, Georgia
NPI 1457081507

Woodly Terry Dominique is a Student in an Organized Health Care Education/Training Program based in Moultrie, GA. Woodly Terry Dominique practices in Moultrie, GA. The NPI Number for Woodly Terry Dominique is 1457081507 and holds a License No. (Georgia).

The current practice location address for Woodly Terry Dominique is 2050 Tallokas Rd, Moultrie, GA and can be reached out via phone at 615-935-8357.

Location: 2050 Tallokas Rd, Moultrie, GA, 31768-7666
person
Provider Profile Details
NPI Number
1457081507
Provider Name
Woodly Terry Dominique
Credential
Provider Entity Type
Individual
Gender
Male
Address
2050 Tallokas Rd, Moultrie, GA, 31768-7666
Phone Number
615-935-8357
Fax Number
Provider Enumeration Date
06/13/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2050 Tallokas Rd
City
State
Zip
31768-7666
Phone Number
615-935-8357
Fax Number
person
Provider Business Mailing Address Details
Address
2050 Tallokas Rd
City
State
Zip
31768-7666
Phone Number
615-935-8357
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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