Individual
JENNIFER DIANE GLISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 DORAL DR, POLAND, OH 44514-1900
(330) 758-0708
(330) 758-1342
Mailing address
337 EWING RD, BOARDMAN, OH 44512-3212
(330) 758-0708
(330) 758-1342
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
OP.017964-S
OH
Other
Enumeration date
02/16/2026
Last updated
02/16/2026
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