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Individual

HEATHER ANN THEOBALD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
33300 N 32ND AVE STE 310, PHOENIX, AZ 85085-8826
(623) 562-3730
(022) 948-2746
Mailing address
2910 N 3RD AVE # 200, PHOENIX, AZ 85013-4434
(602) 406-3181
(022) 642-4176

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
009525
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
150612
AZ
Enumeration date
07/19/2018
Last updated
02/25/2025
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