Individual
SCOTT LAWRENCE TEAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SFIDC
Contact information
Practice address
101 PULLER DR, JACKSONVILLE, NC 28540-6228
(775) 691-6458
Mailing address
101 PULLER DR, JACKSONVILLE, NC 28540-6228
(775) 691-6458
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/22/2011
Last updated
07/22/2011
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