Individual
MR. JARED GIFFORD TETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D., F-AAA
Contact information
Practice address
2234 N WAHSATCH AVE, COLORADO SPRINGS, CO 80907-6940
(719) 632-2376
(719) 633-2327
Mailing address
18 HAWKES TRL, WEBSTER, NY 14580-4211
(585) 672-5761
(585) 244-7126
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11454844
CAQH PROVIDER ID NUMBER
NY
Enumeration date
03/19/2007
Last updated
01/29/2021
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