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General NPI Number Information
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NPI Number | 1790664670
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Entity Type | Individual
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Provider Name | TESS KAMPWERTH
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Gender |
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 1410 N MARKET ST
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City | SPARTA
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State | IL
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Zip | 62286-2302
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Country | US
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Telephone | 618-443-2436
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Fax |
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Provider Business Mailing Address
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Address Line | 601 E KEYS ST
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City | MARISSA
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State | IL
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Zip | 62257-2013
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number |
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License Number State |
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