Individual
CONNIE TETEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3460 PIONEER PKWY, WEST VALLEY CITY, UT 84120-2049
(801) 964-3100
Mailing address
370 E SOUTH TEMPLE, STE 260, SALT LAKE CITY, UT 84111-1206
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5153573-1206
UT
Other
Enumeration date
04/04/2006
Last updated
01/08/2023
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