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1366566416
GRACE M THEODORO
SALT LAKE CITY, UT
NPI
1366566416
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Other Name
GRACIELA H THEODORO
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: AZ 30763)
Enumeration Date
2007-03-16
Last Update Date
2007-07-08
Business Address
Dr. GRACE M THEODORO M.D.
4021 S 700 E STE 300
SALT LAKE CITY, UT 84107-2184
Phone number: 314-432-1805
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Mailing Address
Dr. GRACE M THEODORO M.D.
9 LADUE ESTATES DR
SAINT LOUIS, MO 63141-8321
Phone number: 314-432-1805
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