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Individual

KRISTINE DECOLLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSPT

Contact information

Practice address
1300 VETERANS BLVD, SUITE C, FESTUS, MO 63028-2394
(636) 931-2100
(636) 349-9171
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2008032721
MO

Other

Enumeration date
11/04/2008
Last updated
03/02/2016
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