Most Relevant Information
Provider Data
| NPI Number: | 1003027244 |
| Provider Name: | JACQUELINE GOMES PT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 070-008468 |
Most Important Dates
| Enumeration Date: | 05/26/2007 |
| Last Updated: | 03/15/2010 |
Provider Practice Location
755 N LAKE DR
DU QUOIN
IL
628322451
Practice Location Phone/Fax
| Phone: | 6185423386 |
| Fax: | 6185423386 |
Provider Mailing Location
755 N LAKE DR
DU QUOIN
IL
628322451
Provider Mailing Phone/Fax
| Phone: | 6185423386 |
| Fax: | 6185423386 |