Individual
MARK WILLIAM THENHAUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4930 TAMM AVE, SAINT LOUIS, MO 63109-3160
(314) 312-7102
Mailing address
4930 TAMM AVE, SAINT LOUIS, MO 63109-3160
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2020005815
MO
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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