MICHELLE L THEOBALD

EDINA, MN
NPI1912981341
Former NameMICHELLE L JOHNSON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: MN  9833)
Enumeration Date2005-11-30
Last Update Date2007-10-25
Business Address
-- MICHELLE L THEOBALD PA-C
6405 FRANCE AVE S # SW200
EDINA, MN 55435-2163
Phone number: 952-915-5482
Mailing Address
-- MICHELLE L THEOBALD PA-C
845 RAMSEY AVE
CARVER, MN 55315-4515
Phone number: 952-679-4280