Individual
KAITLIN KNOWLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2802 PINE VALLEY DR, CHAMPAIGN, IL 61822-7984
(217) 530-2176
Mailing address
2802 PINE VALLEY DR, CHAMPAIGN, IL 61822-7984
(217) 530-2176
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/11/2015
Last updated
02/11/2015
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