Individual
KORTE B KNOBLAUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5114 N GLEN PARK PLACE RD, PEORIA, IL 61614-4686
(309) 655-2431
Mailing address
5114 N GLEN PARK PLACE RD, PEORIA, IL 61614-4686
(309) 655-2431
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085005370
IL
Other
Enumeration date
12/29/2014
Last updated
12/29/2014
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