Individual
CASEY KISELEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 S MAIN ST, BELLE RIVE, IL 62810-1228
(618) 316-1626
Mailing address
507 N PEARL ST, MC LEANSBORO, IL 62859-1035
(618) 895-4451
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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