Individual
JOSHUA TELFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
2361 ISABELLA DR, WARRENTON, MO 63383-4475
(636) 359-2188
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012281A
IN
225100000X
Physical Therapist
2016032977
MO
225100000X
Physical Therapist
PT-4743
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
ANTHEM PROVIDER NUMBER - TIN 35-2030653
IN
05
—
PENDING
—
IN
Enumeration date
09/30/2016
Last updated
04/26/2017
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