JASPER BRAYTON TERRY

ALBUQUERQUE, NM
NPI1306149935
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NM  PA2010-0080)
Enumeration Date2010-12-21
Last Update Date2015-11-06
Business Address
-- JASPER BRAYTON TERRY PA-C
1100 CENTRAL AVE SE PMG EMERGENCY MEDICINE
ALBUQUERQUE, NM 87106-4930
Phone number: 505-841-1125
Mailing Address
-- JASPER BRAYTON TERRY PA-C
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770