NPI 1396574877
Mark Thielenhaus
Practice location
- Address
- 622 N Sacramento St, Lodi, CA 95240-1256
- Phone
- (209) 367-9560
- Mailing address
- 525 W Lockeford St, Lodi, CA 95240-1946
Registered specialties
Religious Nonmedical Practitioner
Primary
Registry record
- NPI
- 1396574877
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 31 Jul 2024
- Record last updated
- 31 Jul 2024
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.