NPI 1124661434

Samantha Nicole Thienes

Practitioner Athletic Trainer Cape Girardeau, MO

Practice location

Address: 1 University Plz, Cape Girardeau, MO 63701-4710
Phone: (573) 651-2000
Mailing address: 1622 Indian Summer Dr, Fenton, MO 63026-6948

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

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Registry record

NPI: 1124661434
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Oct 2019
Record last updated: 21 Oct 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.