Individual
GEORGE BYRON GASTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 N MAIN ST, MALTA, OH 43758-9019
(304) 916-8468
Mailing address
220 ELM ST, MARIETTA, OH 45750-2707
(740) 374-8967
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA170928
OH
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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