Individual
KRIS JAMES MANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2014 AUBURN ST, ROCKFORD, IL 61103-4479
(815) 387-1000
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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