Individual
MISS STACI TELLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1076 W CHANDLER BLVD STE 103, CHANDLER, AZ 85224-5223
(480) 821-1997
Mailing address
1076 W CHANDLER BLVD STE 103, CHANDLER, AZ 85224-5223
(480) 821-1997
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7765
AZ
Other
Enumeration date
08/13/2008
Last updated
08/13/2008
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