Individual
JESSICA ANN MARIE GAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
136 W B AVE, KINGMAN, KS 67068-1309
(316) 249-3174
Mailing address
136 W B AVE, KINGMAN, KS 67068-1309
(620) 491-2418
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01-05943
KS
Other
Enumeration date
05/13/2019
Last updated
07/12/2021
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