Individual
KA PO SIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 26TH ST S, GREAT FALLS, MT 59405-5161
(406) 455-5000
Mailing address
5246 S AVERS AVE, CHICAGO, IL 60632-3705
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/25/2026
Last updated
02/25/2026
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