Individual
MR. KENDALL BRENNAN KNOBELOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2100 MADISON AVE, GRANITE CITY, IL 62040-4713
(618) 798-3000
Mailing address
2300 WOODLAWN AVE, GRANITE CITY, IL 62040-4035
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041433013
IL
163W00000X
Registered Nurse
2015031592
MO
Other
Enumeration date
06/13/2017
Last updated
12/11/2019
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