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General NPI Number Information
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NPI Number | 1841430253
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Entity Type | Organization
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Legal Business Name | TERRI L STEDDUM OD LLC
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Dates
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Enumeration Date | 02/25/2009
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 8696 ECKBERG HTS
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City | COLORADO SPRINGS
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State | CO
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Zip | 80924-8149
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Country | US
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Telephone | 901-299-5279
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Fax |
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Provider Business Mailing Address
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Address Line | 412 EAGLERIDGE BLVD
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City | PUEBLO
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State | CO
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Zip | 81008-2100
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Country | US
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Telephone | 719-553-0917
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Fax | 719-553-0918
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. TERRI STEDDUM
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Credential | OD
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Telephone | 719-553-0917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2700
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License Number State | CO
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