Individual
TINA GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
374 N KY 7, SANDY HOOK, KY 41171-7938
(606) 738-6163
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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