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Individual

KIMBERLY KAREN VANTELLMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1204 S 15TH ST, BETHANY, MO 64424-2418
(660) 868-1950
Mailing address
1204 S 15TH ST, BETHANY, MO 64424-2418
(660) 868-1950

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary

Other

Enumeration date
10/25/2022
Last updated
10/25/2022
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