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Individual

KORY MATTHEW KASPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
117 N PITTSBURG LNDG, SPRINGFIELD, IL 62711-8208
(217) 210-1475
Mailing address
117 N PITTSBURG LNDG, SPRINGFIELD, IL 62711-8208
(217) 210-1475

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
10/21/2019
Last updated
10/21/2019
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