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Individual

DOROTHY L TEETS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
3830 S CUSHMAN ST, FAIRBANKS, AK 99701-7530
(907) 455-1416
(907) 455-1460
Mailing address
4352 9TH ST APT 2, FORT WAINWRIGHT, AK 99703-1342
(907) 370-1661

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
6756
AK

Other

Enumeration date
04/05/2011
Last updated
04/05/2011
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