Individual
DR. MIA THOUVENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
12866 TROXLER AVE, HIGHLAND, IL 62249
(618) 236-7444
(618) 726-7444
Mailing address
5139 MATTIS RD STE 102, SAINT LOUIS, MO 63128-2250
(314) 909-1920
(314) 909-1980
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
016.005750
IL
213E00000X
Podiatrist
2013034538
MO
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016.005750
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
2014021282
MO
Other
Enumeration date
10/23/2013
Last updated
07/02/2019
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