Individual
THERESE KISTENFEGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
101 W MCKINLEY AVE, DECATUR, IL 62526-3286
(217) 876-3682
(217) 879-3345
Mailing address
101 W MCKINLEY AVE, DECATUR, IL 62526-3286
(217) 876-3682
(217) 879-3345
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147.001388
IL
Other
Enumeration date
05/27/2014
Last updated
05/27/2014
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