Provider Demographics
NPI:1609696863
Name:HILL, TERRY (LC)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:LC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 HARRELL ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-2932
Mailing Address - Country:US
Mailing Address - Phone:901-907-0640
Mailing Address - Fax:901-255-0758
Practice Address - Street 1:578 HARRELL ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-2932
Practice Address - Country:US
Practice Address - Phone:901-907-0640
Practice Address - Fax:901-255-0758
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty