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MR. THOMAS J. GANTNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
2750 NEWARK GRANVILLE RD, GRANVILLE, OH 43023-9142
(740) 788-9220
(740) 522-8070
Mailing address
2750 NEWARK GRANVILLE RD, GRANVILLE, OH 43023-9142
(740) 788-9220
(740) 522-8070

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50-003782
OH
363AS0400X
Surgical Physician Assistant
Primary
50.003782
OH

Other

Enumeration date
09/19/2013
Last updated
11/11/2021
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