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General NPI Number Information
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NPI Number | 1386009835
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Entity Type | Organization
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Legal Business Name | TETON HEALTHCARE, INC.
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 63 W WILLOWBROOK DR
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City | MERIDIAN
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State | ID
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Zip | 83646-1656
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Country | US
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Telephone | 208-888-7877
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Fax | 208-888-7987
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Provider Business Mailing Address
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Address Line | 63 W WILLOWBROOK DR
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City | MERIDIAN
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State | ID
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Zip | 83646-1656
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Country | US
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Telephone | 208-888-7877
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Fax | 208-888-7987
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Authorized Official
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Title or Position | SECRETARY
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Name | AMBER L TUELLER
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Credential |
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Telephone | 208-207-2726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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