Individual
LUIS TELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
629 PAWNEE ST, LEAVENWORTH, KS 66048-1447
(785) 256-9096
Mailing address
924 W 6TH ST, JUNCTION CITY, KS 66441-3229
(785) 256-9096
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/16/2023
Last updated
05/16/2023
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