Individual
JACK URIAH TEAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
18107 BOTHELL WAY NE, SUITE 106, BOTHELL, WA 98011-1900
(425) 487-3142
(425) 487-8785
Mailing address
9209 126TH AVE NE, KIRKLAND, WA 98033-5901
(425) 827-4758
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00000652
WA
Other
Enumeration date
02/07/2007
Last updated
04/11/2008
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