Individual
DORIS FAY GEARING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
922 BLY ST, JOPPA, IL 36295
(618) 306-3627
Mailing address
1285 BUNCOMBE RD, VIENNA, IL 62995-2537
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.067512
IL
Other
Enumeration date
06/27/2017
Last updated
06/27/2017
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