JAKE GARRETT THEOBALD

SAN DIEGO, CA
NPI1053994327
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2021-05-04
Last Update Date2021-12-03
Business Address
JAKE GARRETT THEOBALD
34101 FARENHOLT AVE
SAN DIEGO, CA 92134-7000
Phone number: 619-532-7968
Mailing Address
JAKE GARRETT THEOBALD
303 COMBINE CT
RICHLANDS, NC 28574-6404
Phone number: 920-287-1256
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