Individual
MS. TEDDRA A MCNEILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 MEADOWBROOK CT, APT A, FAYETTEVILLE, GA 30215-8285
(678) 358-1173
(678) 348-7176
Mailing address
PO BOX 143513, FAYETTEVILLE, GA 30214-6533
(678) 358-1173
(678) 348-7176
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/19/2016
Last updated
09/19/2016
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