Individual
MRS. KENDEL S KNUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
2500 W REYNOLDS ST, PONTIAC, IL 61764-9774
(815) 842-2828
Mailing address
1001 PORTER LN, NORMAL, IL 61761-4215
(815) 985-0101
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056010451
IL
Other
Enumeration date
12/15/2016
Last updated
12/15/2016
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