Individual
JON THOMAS WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4144 LINDELL BLVD, SUITE 310, ST. LOIUS, MO 63108
(314) 531-8224
(314) 531-5683
Mailing address
4144 LINDELL BLVD, SUITE 310, ST. LOIUS, MO 63108
(314) 531-8224
(314) 531-5683
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
001533
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5357960001
—
MO
Enumeration date
09/22/2006
Last updated
07/08/2007
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