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1336569813
MARY KIENSTRA FRESE
GLENVIEW, IL
NPI
1336569813
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171W00000X Contractor
(Licence: IL IN PROGRESS)
Enumeration Date
2014-04-23
Last Update Date
2014-04-23
Business Address
-- MARY KIENSTRA FRESE DT
2244 HENLEY ST
GLENVIEW, IL 60025-4162
Phone number: 314-448-9169
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Mailing Address
-- MARY KIENSTRA FRESE DT
2244 HENLEY ST
GLENVIEW, IL 60025-4162
Phone number: 314-448-9169
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