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Individual

JENNA NICOLE RADVANSKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
4100 JOHNSON RD STE 100, STEUBENVILLE, OH 43952-2356
(740) 264-8600
(740) 346-0298
Mailing address
380 SUMMIT AVENUE, MSO PHYSICIAN BILLING, STEUBENVILLE, OH 43952-2667
(740) 283-7597
(740) 283-7460

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006042RX
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0358704
OH
Enumeration date
05/15/2019
Last updated
08/02/2023
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