Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251E1200X | Ergonomics | ||
N | 225XE1200X | Ergonomics |
NPI | 1659970267 |
---|---|
Provider Name | Mrs. Amanda Sue Kinne |
First Address | Canton, IL 61520-8396 |
Second Address | Canton, IL 61520-1032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2020 |
Last Update Date | 23/10/2020 |