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Individual

KIM SHIRD

Active
Sole proprietor

Provider details

NPI number
Gender
F

Contact information

Practice address
300 SUMMIT ST, GALENA, IL 61036-1638
(815) 777-2836
Mailing address
PO BOX 813, 1255 W. EMPIRE, FREEPORT, IL 61032-0813

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
05/31/2006
Last updated
07/08/2007
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