Individual
COLLINE N GUSSE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1107 S DIVISION AVE, KSB MEDICAL GROUP, ASHTON, IL 61006-0247
(815) 453-1212
(815) 453-2823
Mailing address
PO BOX 247, KSB MEDICAL GROUP, ASHTON, IL 61006-0247
(815) 453-1212
(815) 453-2823
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
IL
Other
Enumeration date
01/27/2006
Last updated
07/09/2007
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