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Raymundo V Teheng

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NPI Number Detailed Information

Provider Information:

Name: Raymundo V Teheng
Gender: M
Provider License Number If Given: 21208

NPI Information:

NPI: 1467446997
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 1/21/2008

Provider Business Mailing Address:

Address: 200 N RIVER ST
Claxton, GA 30417
Phone Number: 9127392509
Fax Number: 9127394989

Provider Business Practice Location Address:

Address: 602 E LONG ST
Claxton, GA 30417
Phone Number: 9127392509
Fax Number: 9127394989

Provider Taxonomy:

Primary: 207V00000X
Secondary (if any):
State: GA

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