Individual
MRS. WENDY KIRSTEN TEETOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
16120 W DODGE RD, OMAHA, NE 68118-2049
(402) 354-0410
(402) 354-0415
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2383
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025895900
—
NE
05
—
1002589600
—
NE
05
—
10025896100
—
NE
05
—
10025941700
—
NE
05
—
10026056700
—
NE
05
—
1006252200
—
NE
05
—
1629044656
—
IA
Enumeration date
02/28/2006
Last updated
01/31/2014
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