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Individual

JORDAN ALAINE TEEPLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RD, LD

Contact information

Practice address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 348-8000
(573) 302-2884
Mailing address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2012026425
MO

Other

Enumeration date
08/28/2012
Last updated
08/28/2012
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