Individual
TEDDY SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101B SOUTH WASINGTON, SEDALIA, MO 65301
(660) 851-0537
(660) 460-7417
Mailing address
101B SOUTH WASINGTON, SEDALIA, MO 65301
(660) 851-0537
(660) 460-7417
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/05/2018
Last updated
09/05/2018
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