Individual
RYAN TEHENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3301 BROADWAY ST, QUINCY, IL 62301-3713
(217) 277-4090
Mailing address
3301 BROADWAY ST, QUINCY, IL 62301-3713
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209024260
IL
367500000X
Certified Registered Nurse Anesthetist
6323
NC
Other
Enumeration date
03/13/2020
Last updated
11/29/2021
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