Individual
MICHAEL TIMOTHY THEOBALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2425 MUSCATINE AVE, IOWA CITY, IA 52240-6647
(319) 358-1358
Mailing address
2425 MUSCATINE AVE, IOWA CITY, IA 52240-6647
(319) 358-1358
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15770
IA
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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