Individual
JESSICA KWONG YUN CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4234 ILLINOIS AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0417
Mailing address
4234 ILLINOIS AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0417
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.147420
OH
Other
Enumeration date
04/23/2021
Last updated
04/20/2026
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