Individual
KRISTEN MIDDENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2149
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2149
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.009819
IL
Other
Enumeration date
01/05/2017
Last updated
01/05/2017
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