Individual
JERRY GILSTRAP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2077 STADIUM DR, WEBB CITY, MO 64870-9743
(417) 673-1933
Mailing address
6880 BEEF BRANCH RD, JOPLIN, MO 64804-8489
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2015008091
MO
Other
Enumeration date
02/18/2016
Last updated
02/18/2016
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