Individual
MRS. JESSICA LANIER GILLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
214 LANE FIELD RD, WARSAW, NC 28398
(910) 293-3144
Mailing address
214 LANEFIELD RD, WARSAW, NC 28398-8719
(910) 293-3144
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4448
NC
Other
Enumeration date
07/28/2017
Last updated
07/21/2022
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