KENDALL C STACKER

BELLEVILLE, IL
NPI1831529239
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy343900000X Non-emergency Medical Transport (VAN)
Additional Taxonomies343900000X Non-emergency Medical Transport (VAN)
Enumeration Date2013-11-21
Last Update Date2013-11-21
Business Address
Mr. KENDALL C STACKER
2745 BROOKMEADOW DR
BELLEVILLE, IL 62221-7116
Phone number: 618-257-3090
Mailing Address
Mr. KENDALL C STACKER
2745 BROOKMEADOW DR
BELLEVILLE, IL 62221
Phone number: 618-257-3090