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1497859037
EVAN B THEOBALD
PAYSON, UT
NPI
1497859037
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: UT 375417-4406)
Enumeration Date
2006-09-12
Last Update Date
2007-07-08
Business Address
-- EVAN B THEOBALD CRNA
1000 E 100 N
PAYSON, UT 84651-1600
Phone number: 800-748-4868
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Mailing Address
-- EVAN B THEOBALD CRNA
32 W 1320 S
PAYSON, UT 84651-3012
Phone number: 801-465-3844
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