Individual
DR. TERESA M THEOBALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
203 N MAIN ST, WAPELLO, IA 52653-1206
(319) 523-4515
Mailing address
203 N MAIN ST, WAPELLO, IA 52653-1206
(319) 523-4515
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
04775
IA
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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