TERRY SMITH

PEORIA, IL
NPI1861582165
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: IL  036-073497)
Additional Taxonomies208000000X Pediatrics
(Licence: IL  036-073497)
Enumeration Date2006-10-15
Last Update Date2007-07-08
Business Address
-- TERRY SMITH
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614-4686
Phone number: 309-683-5600
Mailing Address
-- TERRY SMITH
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614-4686
Phone number: 309-683-5600