Provider Demographics
NPI:1992098404
Name:WALKER, TERRY RAY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:RAY
Last Name:WALKER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9880 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49053-8641
Mailing Address - Country:US
Mailing Address - Phone:269-665-9727
Mailing Address - Fax:269-665-9575
Practice Address - Street 1:9880 E. MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:MI
Practice Address - Zip Code:49053
Practice Address - Country:US
Practice Address - Phone:269-665-9727
Practice Address - Fax:269-665-9575
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302040027183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist