Jeffrey Benjamin Miessau, PA-C

NPI #1689137671 in Peoria, Illinois

Provider Information

NPI Number: 1689137671
Entity Type: Individual
Name: Jeffrey Benjamin Miessau, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Apr 8, 2019
Last Updated: Apr 8, 2019

Practice Location

Address: 7707 N KNOXVILLE AVE STE 200
City: Peoria
State: Illinois
ZIP Code: 61614-2020
Phone: (309) 308-5050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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