Individual
DR. JESSICA COLANESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-7804
Mailing address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2014006545
MO
Other
Enumeration date
06/22/2012
Last updated
04/25/2018
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