Individual
SHANNON RENEE TEDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
156 CROSS POINT DR, OWINGS, MD 20736-3322
(731) 267-8201
Mailing address
156 CROSS POINT DR, OWINGS, MD 20736-3322
(731) 267-8201
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
01/02/2014
Last updated
01/02/2014
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