Individual
JENA B GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4308 BELMONT AVE, YOUNGSTOWN, OH 44505-1052
(330) 759-7038
(330) 759-7071
Mailing address
4308 BELMONT AVE, YOUNGSTOWN, OH 44505-1052
(330) 759-7038
(330) 759-7071
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003058
OH
Other
Enumeration date
05/13/2010
Last updated
02/07/2012
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