Individual
DUSTY R KAESBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
11093 N PRAIRIE RD, RED BUD, IL 62278-4372
(618) 910-1382
Mailing address
11093 N PRAIRIE RD, RED BUD, IL 62278-4372
(618) 910-1382
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057002965
IL
Other
Enumeration date
10/31/2008
Last updated
10/31/2008
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