Individual
ROSS TEEPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2537 W STATE ST STE 200, BOISE, ID 83702-2200
(208) 336-0895
Mailing address
PO BOX 1122, GRAYLING, MI 49738-5122
(989) 745-3608
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
77818
ID
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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