Individual
ALLISON BASTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 S CHESTNUT ST, JEFFERSON, OH 44047-1312
(440) 576-3111
Mailing address
107 S CHESTNUT ST, JEFFERSON, OH 44047-1312
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03438289
OH
Other
Enumeration date
04/07/2020
Last updated
04/07/2020
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