Individual
KYLE ALTENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SRNA
Contact information
Practice address
1 HAIRPIN DRIVE, EDWARDSVILLE, IL 62025
(618) 650-3957
Mailing address
1 HAIRPIN DRIVE, EDWARDSVILLE, IL 62025
(618) 650-3957
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
95238984
CA
Other
Enumeration date
05/26/2026
Last updated
05/26/2026
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