Individual
MRS. MARY ILENE MICHLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DTR
Contact information
Practice address
6420 CLAYTON RD, SAINT LOUIS, MO 63117-1811
(314) 768-8826
Mailing address
6420 CLAYTON RD, SAINT LOUIS, MO 63117-1811
(314) 768-8826
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
—
—
Other
Enumeration date
03/07/2012
Last updated
03/07/2012
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