Individual
BRANDON ALAN TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
32300 S 625 RD, GROVE, OK 74344-6285
(918) 786-2930
Mailing address
PO BOX 451585, GROVE, OK 74345-1585
(918) 786-2930
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
01/17/2023
Last updated
01/17/2023
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