Provider Demographics
NPI:1871739904
Name:LETT, TERESA LYNN (RPH, RRT)
Entity type:Individual
Prefix:MISS
First Name:TERESA
Middle Name:LYNN
Last Name:LETT
Suffix:
Gender:F
Credentials:RPH, RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 240519
Mailing Address - Street 2:575 CLAUDE ROAD, #2000
Mailing Address - City:ECLECTIC
Mailing Address - State:AL
Mailing Address - Zip Code:36024-0020
Mailing Address - Country:US
Mailing Address - Phone:334-541-4433
Mailing Address - Fax:334-541-4436
Practice Address - Street 1:575 CLAUD ROAD
Practice Address - Street 2:SUITE 2000
Practice Address - City:ECLECTIC
Practice Address - State:AL
Practice Address - Zip Code:36024
Practice Address - Country:US
Practice Address - Phone:334-541-2522
Practice Address - Fax:334-541-4436
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11769183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist