NPI 1164693545

Terry L. Pangburn

Practitioner Driver Moulton, IA

Practice location

Address: 109 S Elm St, Moulton, IA 52572-1441
Phone: (641) 856-7734

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 022AA0001 (IA)

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Registry record

NPI: 1164693545
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Mar 2008
Record last updated: 13 Mar 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.