Individual
MR. CHRISTOPHER D THEOBALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2233 STATE ROUTE 86, SARANAC LAKE, NY 12983-5644
(518) 891-4141
Mailing address
2233 STATE ROUTE 86, SARANAC LAKE, NY 12983-5644
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
349696
NY
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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