Individual
MISS JESSICA LYNN GILLENGERTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
4235 GREEN BAY RD., SUITE #10, KENOSHA, WI 53144
(262) 652-1418
Mailing address
4235 GREEN BAY RD., SUITE #10, KENOSHA, WI 53144
(262) 652-1418
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
819-55
WI
Other
Enumeration date
06/30/2015
Last updated
08/07/2015
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