| Doctor Name: | DR. TERRY L COYLE |
| NPI Number: | 1639127780 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.C., F.N.P. |
| License Number: | AP5296 |
| Business Practice Address: | 5130 S Highway 95 Fort Mohave, AZ - 864269374 |
| Business Phone Number: | 9287682811 |
| Business Fax Number: | 9287689787 |
| Mailing Address: | 5130 S Highway 95, FORT MOHAVE |
| State: | AZ |
| Postal Code: | 864269374 |
| Phone Number: | 9287682811 |
| Fax Number: | 9287689787 |
| NPI Enumeration Date: | 05/04/2006 |
| NPI Last Update Date: | 01/31/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP5296 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |