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NPI Code Detail

MEDICARE: TETER ORTHOTICS & PROSTHETICS, INC

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
1332B00000XDurable Medical Equipment & Medical Supplies
2335E00000XProsthetic/Orthotic SupplierMI

Other Identifiers

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

General Provider Information

NPI Number : 1801891973
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 : 1225 W FRONT ST STE A
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-2368
Country : US
Telephone Number : 231-947-5701
Fax Number : 231-947-1370
Authorized Official
Title or Position : REG COMPLIANCE SPECIALIST III
Name : GRACE ANGELINE
Credential :
Telephone Number : 714-961-2102
Provider Enumeration Date : 06/16/2005
Last Update Date : 07/21/2022

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

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