Provider Demographics
NPI:1558180885
Name:MAULL, TERRIE ALEX-ZANDER SR
Entity type:Individual
Prefix:
First Name:TERRIE
Middle Name:ALEX-ZANDER
Last Name:MAULL
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8011 QUAIL HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2828
Mailing Address - Country:US
Mailing Address - Phone:513-200-3146
Mailing Address - Fax:
Practice Address - Street 1:8011 QUAIL HOLLOW CT
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2828
Practice Address - Country:US
Practice Address - Phone:513-200-3146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker