Individual
MONTRELL THORNTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 W PORT PLZ FL 6, SAINT LOUIS, MO 63146-3011
(314) 322-4656
Mailing address
14812 STRATFORD CT, BRIDGETON, MO 63044-1962
(314) 322-4656
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
160510132512859
MO
Other
Enumeration date
06/13/2016
Last updated
11/11/2016
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