Individual
MR. JERED STEVEN GAMBILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSOTR/L
Contact information
Practice address
108 N 3RD ST, MOUNT VERNON, IL 62864-3624
(618) 244-1302
(618) 244-1302
Mailing address
606 E IL HIGHWAY 15, MOUNT VERNON, IL 62864-5072
(618) 241-7039
(618) 241-7039
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.009226
IL
Other
Enumeration date
04/06/2011
Last updated
04/06/2011
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