Individual
MRS. AMANDA SUE KINNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2071 N MAIN ST, CANTON, IL 61520-1032
(309) 647-8100
(309) 647-8580
Mailing address
25788 N VENOVICH RD, CANTON, IL 61520-8396
(309) 221-1094
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051287946
IL
2255A2300X
Athletic Trainer
—
—
225XE1200X
Ergonomics Occupational Therapist
—
—
Other
Enumeration date
10/23/2020
Last updated
10/23/2020
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