MR. James Kevin Gilligan JR., RD, LD

NPI #1629453097 in Mattoon, Illinois

Provider Information

NPI Number: 1629453097
Entity Type: Individual
Name: MR. James Kevin Gilligan JR., RD, LD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dietitian, Registered
Credential: RD, LD
Enumeration Date: Jul 27, 2015
Last Updated: Jul 27, 2015

Practice Location

Address: 501 LAKE LAND BLVD
City: Mattoon
State: Illinois
ZIP Code: 61938-5283
Phone: (217) 258-3370

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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