Individual
MRS. REBECCA MINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
305 W JACKSON ST, SUITE 102, CARBONDALE, IL 62901-1474
(618) 351-9300
Mailing address
305 W JACKSON ST, SUITE 102, CARBONDALE, IL 62901-1474
(618) 351-9300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.003413
IL
Other
Enumeration date
03/17/2009
Last updated
03/17/2009
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