Individual
JESSICA LEIGH GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2704 N CENTER ST, MARYVILLE, IL 62062-5624
(270) 556-8641
Mailing address
2704 N CENTER ST, MARYVILLE, IL 62062-5624
(270) 556-8641
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.004962
IL
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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