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1194869818
TINA-MARIE THIEBAUT
WHEAT RIDGE, CO
NPI
1194869818
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: CO 98117)
Enumeration Date
2007-02-16
Last Update Date
2007-07-08
Business Address
TINA-MARIE THIEBAUT
4803 WARD RD
WHEAT RIDGE, CO 80033-1902
Phone number: 303-743-5855
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Mailing Address
TINA-MARIE THIEBAUT
13272 COLUMBINE CT
THORNTON, CO 80241-2072
Phone number: 303-280-2496
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