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1730166257
JENNIE L GORHAM
SPRINGFIELD, MO
NPI
1730166257
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: MO DO100997)
Enumeration Date
2005-12-27
Last Update Date
2015-01-21
Business Address
-- JENNIE L GORHAM DO
3555 S NATIONAL AVE #302
SPRINGFIELD, MO 65807-7310
Phone number: 417-269-6868
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Mailing Address
-- JENNIE L GORHAM DO
PO BOX 4046
SPRINGFIELD, MO 65808-4046
Phone number: 417-269-5712
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