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1356058259
LELAND CHARLES TEBOUT
BOISE, ID
NPI
1356058259
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163WP2201X Registered Nurse, Ambulatory Care
(Licence: GA RN122374)
Enumeration Date
2022-10-31
Last Update Date
2022-10-31
Business Address
Mr. LELAND CHARLES TEBOUT
500 W FORT ST
BOISE, ID 83702-4501
Phone number: 208-422-1000
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Mailing Address
Mr. LELAND CHARLES TEBOUT
1622 PAUL MADDOX RD
JACKSON, GA 30233-4957
Phone number: 208-422-1000
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