Anthony Teich, RD, LD | |
801 Poleline Rd W, Twin Falls, ID 83301 | |
(208) 814-4120 | |
Not Available |
Full Name | Anthony Teich |
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Gender | Male |
Speciality | Dietitian, Registered |
Location | 801 Poleline Rd W, Twin Falls, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1538616198 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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133V00000X | Dietitian, Registered | D-938 (Idaho) | Secondary |
133V00000X | Dietitian, Registered | 1097741 (* (Not Available)) | Primary |
Provider Name | St Lukes Clinic-treasure Valley Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
Mailing Address | Practice Location Address |
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Anthony Teich, RD, LD 1665 Foxmore St, Pocatello, ID 83204 Ph: () - | Anthony Teich, RD, LD 801 Poleline Rd W, Twin Falls, ID 83301 Ph: (208) 814-4120 |
Abbigail Jean Sundell, RDN Dietitian Medicare: Medicare Enrolled Practice Location: 775 Pole Line Rd W Ste 302, Twin Falls, ID 83301 Phone: 208-814-8780 | |
Shalissa Marie Tomkinson, Dietitian Medicare: Medicare Enrolled Practice Location: 801 Pole Line Rd W Rm H1155, Twin Falls, ID 83301 Phone: 208-814-1016 Fax: 208-814-1931 | |
Evelyn Claire Wiltse, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 801 Pole Line Rd W Rm H1155, Twin Falls, ID 83301 Phone: 208-814-1016 Fax: 208-814-7212 | |
Emmalee Calvert, Dietitian Medicare: Medicare Enrolled Practice Location: 801 Pole Line Rd W Rm H1155, Twin Falls, ID 83301 Phone: 208-814-1016 Fax: 208-814-1931 | |
Kyli Gough, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 496 Shoup Ave W Ste A, Twin Falls, ID 83301 Phone: 208-814-9182 | |
Sonamarivell Granados, RD, LD Dietitian Medicare: Medicare Enrolled Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-4120 Fax: 208-814-4906 | |
Sarah Ann Renaldi, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1016 Fax: 208-814-1931 |