Individual
KYLE JEFFREY THEILMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9630 GROVE CIR N STE 200, MAPLE GROVE, MN 55369-3492
(763) 520-7870
Mailing address
4200 DAHLBERG DR STE 300, GOLDEN VALLEY, MN 55422-4841
(952) 512-5600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14548
MN
Other
Enumeration date
06/22/2023
Last updated
06/28/2023
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