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Individual

DR. ALYSON ANNE THEDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
815 N 5TH AVE UNIT 202, BOZEMAN, MT 59715-2884
(406) 545-2555
(406) 545-2554
Mailing address
7300 RANCH ROAD 2222, BUILDING 1, STE 200, AUSTIN, TX 78730
(512) 628-0465
(512) 233-2711

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
12229855-1205
UT
207ND0101X
MOHS-Micrographic Surgery Physician
12229855-1205
UT

Other

Enumeration date
05/24/2017
Last updated
02/20/2023
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