SearchIllinois225100000X

Mallory Kirsch, DPT

NPI 1891272597 · on the registry since 2018 · sole proprietor

Practice

Address
11545 E Radisson Rd
Mount Vernon, IL 62864
Phone
(618) 316-3727

Additional practice sites

  • 1016 Tacoma Ave, Sunnyside, WA

Registry record

Primary taxonomy
225100000X
225100000X
Also registered as
225100000X
Licence states on file
WA, SC
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2020-07-01

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