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Individual

SHAYE LILLIAN THEOBALD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2155 LAGOMARCINO HALL, AMES, IA 50010
(515) 294-7800
Mailing address
5414 MORTENSEN RD UNIT 302, AMES, IA 50014-8488
(641) 903-6465

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
06/06/2025
Last updated
06/06/2025
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