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NPI Code Detail

MEDICARE: MISS TERESA JO HUTH

MEDICARE: MISS TERESA JO HUTH
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
1164W00000XLicensed Practical NurseLPN065183MEDSOH

General Provider Information

NPI Number : 1912407131
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TERESA JO HUTH
Provider Business Mailing Address
First Line : 502 N MAIN ST
Second Line :
City : FOSTORIA
State : OH
Zip : 44830-2140
Country : US
Telephone Number : 419-934-5474
Fax Number :
Provider Business Practice Location Address
First Line : 22 CLINTON ST
Second Line :
City : BLOOMVILLE
State : OH
Zip : 44818-9399
Country : US
Telephone Number : 419-983-4100
Fax Number : 419-983-4103
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2018
Last Update Date : 02/14/2018

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Directions to “ MISS TERESA JO HUTH ” Practice Location

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