Individual
STACEY GONYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
298 E MOLER ST, COLUMBUS, OH 43207-1239
(614) 906-5272
Mailing address
339 E MAPLE ST, NORTH CANTON, OH 44720-2593
(330) 498-8200
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.008067
OH
Other
Enumeration date
02/21/2019
Last updated
02/21/2019
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