Individual
KELLY GUNDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-4154
(224) 610-3706
Mailing address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-4154
(224) 610-3706
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
4393-046
WI
226300000X
Kinesiotherapist
Primary
—
—
Other
Enumeration date
11/08/2010
Last updated
09/10/2012
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