Individual
ELIZABETH THEOBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4141 SWEENEY LN, HILLSBORO, OH 45133-7429
(937) 509-2516
Mailing address
4141 SWEENEY LN, HILLSBORO, OH 45133-7429
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
148019
OH
Other
Enumeration date
08/16/2013
Last updated
08/16/2013
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