Individual
LAURA GILMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
2401 W MAIN ST, MARION, IL 62959-1188
(262) 914-9884
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
041368421
IL
Other
Enumeration date
04/25/2025
Last updated
04/25/2025
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