Individual
MRS. ANNETTE C THEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
9435 ELK GROVE BLVD, ELK GROVE, CA 95624-5013
(916) 714-6955
(916) 714-6409
Mailing address
9676 PASTURE ROSE WAY, ELK GROVE, CA 95624-6072
(916) 730-3104
(916) 714-1798
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
50673
CA
Other
Enumeration date
05/17/2014
Last updated
05/17/2014
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