Individual
JESSICA GATLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
131 LINCOLN PLACE CT, BELLEVILLE, IL 62221-5825
(314) 786-2870
Mailing address
1206 RIDGE AVE, COLLINSVILLE, IL 62234-4538
(618) 917-5063
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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