Individual
MR. KEVIN NORMAN REISECK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7529
(618) 463-7808
Mailing address
454 FLORIDA DR, EAST ALTON, IL 62024-1820
(618) 259-7322
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
03/29/2006
Last updated
07/08/2007
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