Individual
DR. KRISTI KAY DIECKMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C., M.S.
Contact information
Practice address
1210 PARAGON DR, SUITE 1B, O FALLON, IL 62269-1773
(618) 973-5522
Mailing address
1210 PARAGON DR, SUITE 1B, O FALLON, IL 62269-1773
(618) 973-5522
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
038.011634
IL
111NR0400X
Rehabilitation Chiropractor
2010003872
MO
Other
Enumeration date
06/14/2010
Last updated
06/14/2010
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