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1003211012
THERESA KAUTH
BLOOMINGTON, IL
NPI
1003211012
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209.011910)
Enumeration Date
2014-11-03
Last Update Date
2015-05-06
Business Address
-- THERESA KAUTH
108 W MARKET ST
BLOOMINGTON, IL 61701-3918
Phone number: 309-827-5351
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Mailing Address
-- THERESA KAUTH
108 W MARKET ST
BLOOMINGTON, IL 61701-3918
Phone number: 309-827-5351
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