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Individual

SAMANTHA NICOLE THIENES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1 UNIVERSITY PLZ, CAPE GIRARDEAU, MO 63701-4710
(573) 651-2000
Mailing address
1622 INDIAN SUMMER DR, FENTON, MO 63026-6948
(314) 775-6947

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
10/21/2019
Last updated
10/21/2019
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