Individual
KELSIE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 W LORTON ST, ROODHOUSE, IL 62082-1514
(217) 408-8598
Mailing address
202 W LORTON ST, ROODHOUSE, IL 62082-1514
(217) 408-8598
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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