Provider Demographics
NPI:1174698526
Name:TETER, MELVIN C (RPT)
Entity type:Individual
Prefix:MR
First Name:MELVIN
Middle Name:C
Last Name:TETER
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:MR
Other - First Name:M
Other - Middle Name:CRIS
Other - Last Name:TETER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPT
Mailing Address - Street 1:3500 SW 10TH AVE
Mailing Address - Street 2:THE CAPPER FOUNDATION EASTER SEALS
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-1995
Mailing Address - Country:US
Mailing Address - Phone:785-272-4060
Mailing Address - Fax:785-272-7912
Practice Address - Street 1:3500 SW 10TH AVE
Practice Address - Street 2:THE CAPPER FOUNDATION EASTER SEALS
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-1995
Practice Address - Country:US
Practice Address - Phone:785-272-4060
Practice Address - Fax:785-272-7912
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1102675225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS059729OtherBCBS KS