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Individual

MR. JOHN THOMAS GIOVENGO IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS,ATC,PTA

Contact information

Practice address
408 WATER ST, BENWOOD, WV 26031-1124
(304) 233-9091
Mailing address
408 WATER ST, BENWOOD, WV 26031-1124

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
01/28/2008
Last updated
01/28/2008
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