Individual
JATANA GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
459 MARY LN, SOUTH LEBANON, OH 45065-1315
(520) 658-8892
Mailing address
PO BOX 308, WAYNESVILLE, OH 45068-0308
(520) 658-8892
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
03/17/2022
Last updated
03/17/2022
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