Individual
DR. KEVIN C TEAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1829 NEBRASKA AVE, GRANTS PASS, OR 97527-5701
(541) 474-2225
(541) 474-2229
Mailing address
1829 NEBRASKA AVE, GRANTS PASS, OR 97527-5701
(541) 474-2225
(541) 474-2229
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3232
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3232
STATE LICENSE #
OR
01
—
93-1325306
TAX ID #
OR
Enumeration date
01/04/2007
Last updated
04/09/2009
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