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Individual

MR. GARY GUMMERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
320 E CARPENTER ST, SUITE 1-B, SPRINGFIELD, IL 62702-5185
(217) 744-8000
Mailing address
320 E CARPENTER ST, SUITE 1-B, SPRINGFIELD, IL 62702-5185
(217) 744-8000

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
70015971
IL
225100000X
Physical Therapist
7321
MN

Other

Enumeration date
08/13/2007
Last updated
09/10/2007
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