Provider Demographics
NPI:1356025365
Name:TURNER, MICHELE (DAOM)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 S JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63118-3926
Mailing Address - Country:US
Mailing Address - Phone:619-502-1558
Mailing Address - Fax:314-722-4326
Practice Address - Street 1:2006 S 39TH ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-3717
Practice Address - Country:US
Practice Address - Phone:314-772-4325
Practice Address - Fax:314-772-4326
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019002746171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty