Individual
JENNA DORNAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 MEMORIAL DR, BELLEVILLE, IL 62226-5360
(618) 233-7750
Mailing address
5800 HIGHLANDS PLAZA DR APT 133, SAINT LOUIS, MO 63110-1358
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/30/2019
Last updated
12/29/2021
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