Individual
THERESA ANNE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1450 DARTMOUTH DR, SAINT CHARLES, MO 63303-3659
(636) 395-7073
(636) 395-7073
Mailing address
1450 DARTMOUTH DR, SAINT CHARLES, MO 63303-3659
(636) 395-7073
(636) 395-7073
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2007002928
MO
Other
Enumeration date
05/26/2010
Last updated
05/26/2010
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