Individual
MARK THERIAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1895 N HIGHWAY 16, DENVER, NC 28037-8642
(704) 489-2273
(704) 489-2274
Mailing address
PO BOX 1375, DENVER, NC 28037-2004
(704) 489-2273
(704) 489-2274
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2346
NC
Other
Enumeration date
07/28/2005
Last updated
03/22/2010
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