MR. Frederick Otto Kist

NPI #1366450769 in Inverness, Illinois

Provider Information

NPI Number: 1366450769
Entity Type: Individual
Name: MR. Frederick Otto Kist
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Enumeration Date: Aug 3, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1615 PHEASANT TRL
City: Inverness
State: Illinois
ZIP Code: 60067-4619
Phone: (847) 358-6526

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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