NPI 1891260931

Kevin Wayne Kackley, DVM

Practitioner Prevention Professional Mt Sterling, IL

Practice location

Address: 897 850e St, Mt Sterling, IL 62353-1798
Phone: (217) 773-3366
Fax: (217) 773-4646
Mailing address: PO Box 228, Mt Sterling, IL 62353-0228

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 090-005298 (IL)

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Registry record

NPI: 1891260931
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Oct 2018
Record last updated: 4 Oct 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.