Organization
TEETER PEDIATRIC CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYNI L TEETER M.D. (OWNER)
(417) 437-0242
Entity
Organization
Contact information
Practice address
3126 WISCONSIN AVE, JOPLIN, MO 64804-2873
(417) 437-0242
Mailing address
3126 WISCONSIN AVE, JOPLIN, MO 64804-2873
(417) 437-0242
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2005013271
MO
Other
Enumeration date
03/11/2011
Last updated
03/11/2011
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