Individual
KIMBERLY ANN VICTORINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1741 W DIVISION ST, CHICAGO, IL 60622-3216
(773) 904-2462
Mailing address
1741 W DIVISION ST, CHICAGO, IL 60622-3216
(773) 904-2462
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198.001404
IL
Other
Enumeration date
01/31/2019
Last updated
01/31/2019
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