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Individual

KYLE KLEINSCHMIDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3119 WASHINGTON AVE, ALTON, IL 62002-5473
(618) 463-9490
(618) 463-9491
Mailing address
3119 WASHINGTON AVE, ALTON, IL 62002-5473
(618) 463-9490
(618) 463-9491

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
3207
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3207
HEARING AID DISPENSER LICENSE
IL
Enumeration date
07/28/2015
Last updated
07/28/2015
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