Individual
JUSTIN GRANT GATEWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
664 LIBERTY ST, PAINESVILLE, OH 44077-3661
(440) 251-1854
Mailing address
664 LIBERTY ST, PAINESVILLE, OH 44077-3661
(440) 251-1854
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
416010
OH
Other
Enumeration date
12/30/2019
Last updated
12/30/2019
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