Individual
SOPHAI THACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9717 LANDMARK PARKWAY DR, SAINT LOUIS, MO 63127-1628
(314) 722-6555
Mailing address
2090 HACKMANN ESTATES DR, SAINT CHARLES, MO 63303-4471
(314) 546-3572
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F09190892
MO
Other
Enumeration date
11/06/2019
Last updated
11/06/2019
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