Individual
KELLY KUNTZENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4106 CUMMINS ST, PLANO, IL 60545-2220
(630) 220-1193
Mailing address
4106 CUMMINS ST, PLANO, IL 60545-2220
(630) 220-1193
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.006829
IL
Other
Enumeration date
07/27/2015
Last updated
07/27/2015
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