Individual
MADISON SYLVIA TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2310 CALIFORNIA RD, ELKHART, IN 46514-1228
(574) 264-0791
Mailing address
111 CAPERIOLE PL, FORT WAYNE, IN 46825-8307
(631) 806-2971
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31007568A
IN
Other
Enumeration date
10/16/2021
Last updated
03/24/2023
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