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General NPI Number Information
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NPI Number | 1255630943
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Entity Type | Individual
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Provider Name | TEDDY TONY TEHENSKY JR.
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Gender | Male
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 17 WASHINGTON
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City | MONROE
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State | MI
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Zip | 48161
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Country | US
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Telephone | 734-322-3365
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Fax |
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Provider Business Mailing Address
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Address Line | 17 WASHINGTON ST
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City | MONROE
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State | MI
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Zip | 48161-2508
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Country | US
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Telephone | 734-322-3365
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 3501005090
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License Number State | MI
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