KENDRA MICKELSON

EUREKA, IL
NPI1992158356
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy314000000X Skilled Nursing Facility
(Licence: IL  0042424)
Additional Taxonomies314000000X Skilled Nursing Facility
(Licence: IL  1694647)
Enumeration Date2016-07-20
Last Update Date2016-07-20
Business Address
-- KENDRA MICKELSON
700 N MAIN ST
EUREKA, IL 61530-1085
Phone number: 309-467-9094
Mailing Address
-- KENDRA MICKELSON
700 N MAIN ST
EUREKA, IL 61530-1085
Phone number: 309-467-9094