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1154994036
CLAY DALTON THEBEAU
SAINT LOUIS, MO
NPI
1154994036
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO 2021022097)
Enumeration Date
2021-07-20
Last Update Date
2021-07-20
Business Address
CLAY DALTON THEBEAU ATC
1 COLLEGE PARK DR
SAINT LOUIS, MO 63141-8660
Phone number: 314-434-1115
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Mailing Address
CLAY DALTON THEBEAU ATC
1 COLLEGE PARK DR
SAINT LOUIS, MO 63141-8660
Phone number: 314-434-1115
Copy
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