Individual
TERESA L COON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1004 STATE ST, BETTENDORF, IA 52722-4856
(563) 359-5535
Mailing address
217 4TH AVE W, GRINNELL, IA 50112-1895
(641) 236-7524
(641) 236-7944
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32230
IA
207QA0505X
Adult Medicine Physician
32230
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00742669
RAILROAD MEDICARE
IA
Enumeration date
08/22/2006
Last updated
02/27/2019
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