Courtney L Teller, PA-C

NPI #1417208505 in Dixon, Illinois

Provider Information

NPI Number: 1417208505
Entity Type: Individual
Name: Courtney L Teller, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Sep 28, 2012
Last Updated: Aug 27, 2018

Practice Location

Address: 102 S HENNEPIN AVE
City: Dixon
State: Illinois
ZIP Code: 61021-3013
Phone: (815) 285-8523

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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