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General NPI Number Information
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NPI Number | 1306174529
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Entity Type | Individual
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Provider Name | MR. VICTOR TEEM
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Gender | Male
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Dates
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Enumeration Date | 11/29/2009
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Last Update Date | 11/29/2009
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Provider Practice Location Address
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Address Line | 2300 GLADES RD SUITE 202E
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City | BOCA RATON
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State | FL
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Zip | 33431-7386
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Country | US
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Telephone | 800-681-2056
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Fax | 866-689-6058
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Provider Business Mailing Address
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Address Line | 209 WATSON CIR
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City | LINCOLN
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State | AL
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Zip | 35096-9364
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Country | US
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Telephone | 205-763-0386
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Fax | 205-763-3104
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA000779
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License Number State | GA
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