Search › Illinois › 222Q00000X
Kelly Bault
NPI 1467749085 · on the registry since 2011 · sole proprietor
Practice
- Address
- 1800 Old West Main St Apt 204
Carbondale, IL 62901 - Phone
- (815) 343-2776
Registry record
- Primary taxonomy
- 222Q00000X
222Q00000X
- Sex
- Female
- Record last updated
- 2011-07-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois