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1124627898
MIKAELA THEOBALD
RAPID CITY, SD
NPI
1124627898
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2020-10-22
Last Update Date
2023-06-29
Business Address
MIKAELA THEOBALD PA-C
353 FAIRMONT BLVD
RAPID CITY, SD 57701-7375
Phone number: 605-755-1000
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Mailing Address
MIKAELA THEOBALD PA-C
353 FAIRMONT BLVD
RAPID CITY, SD 57701-7375
Phone number: 605-755-1000
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