Individual
DONALD EUGENE KALLEMBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
1224 W LAUREL ST, SPRINGFIELD, IL 62704-3529
(314) 546-8840
Mailing address
1224 W LAUREL ST, SPRINGFIELD, IL 62704-3529
(314) 546-8840
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056004959
IL
Other
Enumeration date
06/17/2013
Last updated
06/17/2013
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