Individual
JESSICA SPENCER GILLISPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16 WALNUT AVE SW, ROANOKE, VA 24016-4719
(540) 345-6468
(540) 345-3204
Mailing address
16 WALNUT AVE SW, ROANOKE, VA 24016-4719
(540) 345-6468
(540) 345-3204
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004115
VA
Other
Enumeration date
01/10/2013
Last updated
02/17/2020
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