Individual
NATALIE THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 CLIFTON ST, COLLINSVILLE, IL 62234-4214
(618) 795-0097
Mailing address
1215 CLIFTON ST, COLLINSVILLE, IL 62234-4214
(618) 795-0097
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
03/18/2022
Last updated
03/18/2022
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