Richard Todd Kerr, PA-C, ATC
Physician Assistant in Peoria, IL. Individual provider (NPI-1).
NPI number1881662385
StatusActive
Last updated in NPPESDec 1, 2011
Details
- NPI
- 1881662385
- Entity type
- Individual (NPI-1)
- Name
- Mr. Richard Todd Kerr
- Credential
- PA-C, ATC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 9, 2006
- Last updated
- Dec 1, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085004215 | IL | Yes |
Practice location
303 N William Kumpf BlvdPeoria, IL 61605-2507
Phone 309-676-5546
Mailing address
303 N William Kumpf BlvdPeoria, IL 61605-2507
Phone 309-676-5546
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