Individual
JILL LORRAINE GAVASTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
709 4TH AVE, FORD CITY, PA 16226
(724) 954-2504
Mailing address
709 4TH AVE, FORD CITY, PA 16226
(724) 954-3504
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
273254
PA
164W00000X
Licensed Practical Nurse
5264837
FL
Other
Enumeration date
01/20/2025
Last updated
01/20/2025
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