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1396842480
LAURA R KIDD
CARBONDALE, IL
NPI
1396842480
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Former Name
LAURA R WILLENBORG
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085.002750)
Enumeration Date
2006-09-20
Last Update Date
2022-07-21
Business Address
LAURA R KIDD P.A.
305 W JACKSON ST STE 200
CARBONDALE, IL 62901-1474
Phone number: 618-536-6621
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Mailing Address
LAURA R KIDD P.A.
305 W JACKSON ST STE 200
CARBONDALE, IL 62901-1474
Phone number: 618-536-6621
Copy
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