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1093242778
MARK GILLMAN
OTTUMWA, IA
NPI
1093242778
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IA 15002)
Enumeration Date
2017-05-12
Last Update Date
2017-05-12
Business Address
-- MARK GILLMAN BA, CADC
310 W. MAIN ST
OTTUMWA, IA 52501
Phone number: 641-683-6747
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Mailing Address
-- MARK GILLMAN BA, CADC
PO BOX 658
OTTUMWA, IA 52501
Phone number: 641-683-6747
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