Individual
KENT KUNKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
215 RICHARD A MAUTINO DR, SPRING VALLEY, IL 61362-1144
(815) 664-5331
(815) 663-5057
Mailing address
215 RICHARD A MAUTINO DR, SPRING VALLEY, IL 61362-1144
(815) 664-5331
(815) 663-5057
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008411
IL
Other
Enumeration date
01/18/2007
Last updated
12/08/2010
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