Individual
GRACE ALEXANDRA TEDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 S MARTIN LUTHER KING JR DR, WINSTON SALEM, NC 27110-0003
(336) 750-2000
Mailing address
133 RIVER HILL DR, ADVANCE, NC 27006-9599
(336) 529-9602
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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