MEDICARE: TETER ORTHOTICS & PROSTHETICS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier		MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225078298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TETER ORTHOTICS & PROSTHETICS, INC

Provider Business Mailing Address
First Line	:	PO BOX 650846
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75265-0846
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4024 PARK EAST CT SE STE B
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-8810
Country	:	US
Telephone Number	:	616-949-4050
Fax Number	:	616-949-4051

Authorized Official
Title or Position	:	REG COMPLIANCE SPECIALIST III
Name	:	GRACE ANGELINE
Credential	:
Telephone Number	:	714-961-2102

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	07/21/2022

Similar Medicare Providers

1174898522 — RENAL AND HYPERTENSION SPECIALISTS, PLLC
Practice Location Address:

4024 PARK EAST CT SE , SUITE C
GRAND RAPIDS, MI
49546-8810

Practice Phone: 616-516-2192
Practice Fax:

1992215768 — HEATHER METZ AGNP-C
Practice Location Address:

4024 PARK EAST CT SE
GRAND RAPIDS, MI
49546-8810

Practice Phone: 616-727-0083
Practice Fax: 866-493-3535

1760017461 — ALISON BEVERLY CAFFREY PA-C
Practice Location Address:

4024 PARK EAST CT SE
GRAND RAPIDS, MI
49546-8810

Practice Phone: 231-592-1360
Practice Fax: 231-592-1361

1013506625 — KATELYN GOFF PA
Practice Location Address:

4024 PARK EAST CT SE
GRAND RAPIDS, MI
49546-8810

Practice Phone: 231-592-1360
Practice Fax: 231-592-1361

1528711108 — KYLEIGH CHRISTINE EGNATUK PA-C
Practice Location Address:

4024 PARK EAST CT SE STE C
GRAND RAPIDS, MI
49546-8810

Practice Phone: 616-975-1186
Practice Fax:

1447973060 — WEST MICHIGAN PAIN CENTER PC
Practice Location Address:

4024 PARK EAST CT SE
GRAND RAPIDS, MI
49546-8810

Practice Phone: 616-727-0083
Practice Fax: 866-493-3535

Directions to “TETER ORTHOTICS & PROSTHETICS, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.