Thomas Dannenberg, MAEd, LAT, ATC
Specialist/Technologist, Athletic Trainer in Saint Charles, MO. Individual provider (NPI-1).
NPI number1255865754
StatusActive
Last updated in NPPESJun 15, 2023
Details
- NPI
- 1255865754
- Entity type
- Individual (NPI-1)
- Name
- Thomas Dannenberg
- Credential
- MAEd, LAT, ATC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 12, 2017
- Certification date
- Jun 15, 2023
- Last updated
- Jun 15, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 2014025141 | MO | Yes |
Practice location
209 S Kingshighway StSaint Charles, MO 63301-1693
Phone 618-560-3298
Mailing address
1015 Corporate Square Dr Ste 220Saint Louis, MO 63132-2938
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