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Individual

CARLY TEETERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
W68N611 EVERGREEN BLVD, CEDARBURG, WI 53012-1847
(262) 492-9567
Mailing address
4540 W COUNTRY VIEW DR, MEQUON, WI 53092-2130

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1611-39
WI

Other

Enumeration date
04/29/2020
Last updated
04/29/2020
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