Individual
JENNIFER GANTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7589 TYLERS PLACE BLVD, WEST CHESTER, OH 45069-6308
(513) 755-4700
(513) 755-4717
Mailing address
7589 TYLERS PLACE BLVD, WEST CHESTER, OH 45069-6308
(513) 755-4700
(513) 755-4717
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
55000068RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50002036
PA
OH
Enumeration date
10/22/2008
Last updated
02/07/2013
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