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Individual

JEAN GASANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
14200 LAUREL PARK DR, LAUREL, MD 20707-5201
(410) 724-3423
Mailing address
4515 BOASTFIELD LN, OLNEY, MD 20832-2068
(301) 503-7607

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
A3485
MD
225200000X
Physical Therapy Assistant
Primary
PT-2023-2288
NM

Other

Enumeration date
02/12/2019
Last updated
08/01/2024
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