| NPI | 1720173909 |
|---|---|
| Other Name | THEOBALD FAMILY EYE CARE |
| Entity Type | Organization |
| Authorized Contact | TERESA THEOBALD Owner/Partner 218-727-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |