Individual
MR. KEVIN MICHAEL NORRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19608 MEG LN, CARLYLE, IL 62231-5489
(618) 531-0243
(618) 749-5384
Mailing address
19608 MEG LN, CARLYLE, IL 62231-5489
(618) 531-0243
(618) 749-5384
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
N62051366057
IL
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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