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NPI Code Detail

MEDICARE: MISS ANN-MAREE TEDALDI DPT, PHD

MEDICARE: MISS ANN-MAREE TEDALDI DPT, PHD
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
1225100000XPhysical Therapist1158813TX

General Provider Information

NPI Number : 1871678227
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ANN-MAREE TEDALDI DPT, PHD
Provider Business Mailing Address
First Line : 3001 S JACKSON ST
Second Line :
City : SAN ANGELO
State : TX
Zip : 76904-5129
Country : US
Telephone Number : 210-482-9744
Fax Number :
Provider Business Practice Location Address
First Line : 3001 S JACKSON ST
Second Line :
City : SAN ANGELO
State : TX
Zip : 76904-5129
Country : US
Telephone Number : 325-223-6304
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 02/07/2023

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Directions to “ MISS ANN-MAREE TEDALDI DPT, PHD” Practice Location

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