Tina-Marie Thiebaut

NPI #1194869818 in Wheat Ridge, Colorado

Provider Information

NPI Number: 1194869818
Entity Type: Individual
Name: Tina-Marie Thiebaut
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Internal Medicine
Enumeration Date: Feb 16, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 4803 WARD RD
City: Wheat Ridge
State: Colorado
ZIP Code: 80033-1902
Phone: (303) 743-5855

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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