Individual
JENNIFER GANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1918 17TH ST, ROCK ISLAND, IL 61201-4355
(309) 798-4785
Mailing address
1918 17TH ST, ROCK ISLAND, IL 61201-4355
(309) 798-4785
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
03/02/2017
Last updated
03/02/2017
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