Individual
MR. NATHAN JOSEPH WILMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED. ATC, LAT, CSCS
Contact information
Practice address
4800 MEXICO RD, SUITE 104, SAINT PETERS, MO 63376-1666
(636) 928-4199
Mailing address
18 LONE EAGLE TRL, SAINT CHARLES, MO 63303-6204
(636) 928-4342
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
115091
MO
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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