Individual
COLLEEN JOCKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 MATC, COLUMBIA, MO 65201
(407) 467-4686
Mailing address
4930 W MILLBROOK DR, COLUMBIA, MO 65203-5327
(407) 467-4686
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2012026119
MO
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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