Mark Daniels, L.A.T., M.S., A.T.C.
Specialist in Webster Groves, MO. Individual provider (NPI-1).
NPI number1205249257
StatusActive
Last updated in NPPESJun 7, 2014
Details
- NPI
- 1205249257
- Entity type
- Individual (NPI-1)
- Name
- Mark Daniels
- Credential
- L.A.T., M.S., A.T.C.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 7, 2014
- Last updated
- Jun 7, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 00036 | MO | Yes |
Practice location
630 S Elm AveWebster Groves, MO 63119-4047
Phone 417-839-9920
Mailing address
630 S Elm AveWebster Groves, MO 63119-4047
Phone 417-839-9920
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