| NPI | 1710035324 |
|---|---|
| Other Name | JERRY LEE TENNANT |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX D1830) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX D1830) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-07-08 |