Provider Information for 1114608320
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TEELA RUEHLE
Sex: Female
NPI: 1114608320
Last Updated: 2023-07-31
Certification Date: 2023-07-30
Certification Date: 2023-07-30
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1114608320 | ||||||||
| Enumeration Date | 2023-07-31 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 5594 POKAGON RD BERRIEN SPRINGS, MI 49103-1559 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 5594 POKAGON RD BERRIEN SPRINGS, MI 49103 United States Phone: 517-290-1518 | Fax: | ||||||||
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