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Individual

MS. ERIN MARIE THILTGEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
806 A STATE ROUTE 72 EAST, ROLLA, MO 65401
(573) 808-0157
Mailing address
806 A ST ROUTE 72 EAST, ROLLA, MO 65401
(573) 808-0157

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2006025648
MO

Other

Enumeration date
09/14/2012
Last updated
09/14/2012
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