Individual
DR. JASON ELLIOTT GINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, MDIV, PHD
Contact information
Practice address
315 S ALLEN ST STE 326, STATE COLLEGE, PA 16801-4851
(814) 419-0781
Mailing address
PO BOX 594, STATE COLLEGE, PA 16804-0594
(814) 232-1962
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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