Individual
MR. EDWARD TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 W HICKORY ST, DEMING, NM 88030-4046
(575) 546-2174
Mailing address
901 W HICKORY ST, DEMING, NM 88030-4046
(575) 546-2174
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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