Individual
MICHAEL THEILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
15754 N BULLARD AVE, SURPRISE, AZ 85374-8839
(414) 333-3416
Mailing address
4612 W BERKSHIRE DR, FRANKLIN, WI 53132-8172
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/06/2017
Last updated
01/13/2022
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