Provider Demographics
NPI:1477434165
Name:THORN, ZACH (DPT)
Entity type:Individual
Prefix:
First Name:ZACH
Middle Name:
Last Name:THORN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 S SKINKER BLVD APT 17D
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-2355
Mailing Address - Country:US
Mailing Address - Phone:636-223-5700
Mailing Address - Fax:
Practice Address - Street 1:118 RICHARDSON XING
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-6023
Practice Address - Country:US
Practice Address - Phone:636-206-4146
Practice Address - Fax:636-223-2542
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025037994225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist