Individual
KICA CHRISTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
925 HWY V.V., KENNETT, MO 63857
(573) 888-5925
Mailing address
579 HWY J N, HAYTI, MO 63851
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/16/2014
Last updated
05/16/2014
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