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1073569745
ANN H THEDIECK
GREEN RIVER, WY
NPI
1073569745
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: WY 6716A)
Enumeration Date
2006-05-25
Last Update Date
2007-07-08
Business Address
Dr. ANN H THEDIECK MD
1400 UINTA DR
GREEN RIVER, WY 82935-5046
Phone number: 307-872-4500
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Mailing Address
Dr. ANN H THEDIECK MD
PO BOX 219
GREEN RIVER, WY 82935-0219
Phone number: 307-872-4500
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