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General NPI Number Information
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NPI Number | 1912021312
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Entity Type | Individual
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Provider Name | JARED GIFFORD TETER AU.D., F-AAA
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Gender | Male
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 2234 N WAHSATCH AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-6940
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Country | US
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Telephone | 719-632-2376
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Fax | 719-633-2327
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Provider Business Mailing Address
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Address Line | 18 HAWKES TRL
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City | WEBSTER
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State | NY
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Zip | 14580-4211
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Country | US
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Telephone | 585-672-5761
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Fax | 585-244-7126
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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