Provider Demographics
NPI:1336957968
Name:TEAGUE, DREW ALEXANDER
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:ALEXANDER
Last Name:TEAGUE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5703 N COUNTY ROAD 500 E
Mailing Address - Street 2:
Mailing Address - City:MOORELAND
Mailing Address - State:IN
Mailing Address - Zip Code:47360-9768
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5703 N COUNTY ROAD 500 E
Practice Address - Street 2:
Practice Address - City:MOORELAND
Practice Address - State:IN
Practice Address - Zip Code:47360-9768
Practice Address - Country:US
Practice Address - Phone:765-524-3339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist