Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MARK J THIBAULT, MD
ActivePhysical Medicine & Rehabilitation · SARTELL, MN
Registration Details
- NPI Number
- 1679507776
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 11, 2006 (19.821297894251 yrs)
- Last Updated
- Feb 24, 2021
- License
-
32514 (MN)
Practice Information
- Address
-
1901 CONNECTICUT AVE SSARTELL, MN, 563772554Browse MN providers · Browse ZIP 56377
- Phone
- 3202594100
- Fax
- 3202575523
- Primary Specialty
-
Physical Medicine & Rehabilitation
208100000X
Other Physical Medicine & Rehabilitation Providers in SARTELL, MN
| Name | Credential | NPI |
|---|---|---|
| RAMON P SOTTO | MD | 1972580454 |
| SARA ASHLEY BOTTERILL | M.D. | 1881809549 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.