Kyle John Blievernicht, MOT

NPI #1154970721 in Glen Carbon, Illinois

Provider Information

NPI Number: 1154970721
Entity Type: Individual
Name: Kyle John Blievernicht, MOT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Credential: MOT
Enumeration Date: Sep 6, 2019
Last Updated: Sep 6, 2019

Practice Location

Address: 4955 S STATE ROUTE 159 STE B
City: Glen Carbon
State: Illinois
ZIP Code: 62034-1907
Phone: (618) 288-4677

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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