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1760415947
SHANE THEOBALD
CHANDLER, AZ
NPI
1760415947
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: AZ 1521)
Enumeration Date
2006-07-09
Last Update Date
2014-03-04
Business Address
-- SHANE THEOBALD OD
1717 W. CHANDLER BLVD
CHANDLER, AZ 85224
Phone number: 480-821-7565
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Mailing Address
-- SHANE THEOBALD OD
25500 N. NORTERRA PARKWAY, BLDG B
PHOENIX, AZ 85085
Phone number: 623-277-1000
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