Mark Daniels, L.A.T., M.S., A.T.C.

NPI #1205249257 in Webster Groves, Missouri

Provider Information

NPI Number: 1205249257
Entity Type: Individual
Name: Mark Daniels, L.A.T., M.S., A.T.C.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: L.A.T., M.S., A.T.C.
Enumeration Date: Jun 7, 2014
Last Updated: Jun 7, 2014

Practice Location

Address: 630 S ELM AVE
City: Webster Groves
State: Missouri
ZIP Code: 63119-4047
Phone: (417) 839-9920

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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