Individual
MRS. VICKI SUE TEDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SNT
Contact information
Practice address
17 SCHOOL ST, PERU, NY 12972-2616
(518) 643-6442
(518) 642-6415
Mailing address
17 SCHOOL ST, PERU, NY 12972-2616
(518) 643-6442
(518) 642-6415
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
383569
NY
Other
Enumeration date
12/01/2011
Last updated
12/01/2011
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