JACK GREGORY ALLEN
Individual Provider (NPI-1)
Active
Student in an Organized Health Care Education/Training Program
Provider Information
- NPI Number
1447190186- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 1100 VIRGINIA AVE, COLUMBIA, MO, 652120001
- Phone
- (573) 884-7796
Specialties & Taxonomies
Student in an Organized Health Care Education/Training Program
Primary License: MO
All Addresses
MAILING
1612 TENNIS LN
SHEBOYGAN, WI, 530833457