Most Relevant Information
Provider Data
| NPI Number: | 1003242298 |
| Provider Name: | THOMAS J. GANTNER PAC |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 50-003782 |
Most Important Dates
| Enumeration Date: | 09/19/2013 |
| Last Updated: | 11/11/2021 |
Provider Practice Location
2750 NEWARK GRANVILLE RD
GRANVILLE
OH
430239142
Practice Location Phone/Fax
| Phone: | 7407889220 |
| Fax: | 7405228070 |
Provider Mailing Location
2750 NEWARK GRANVILLE RD
GRANVILLE
OH
430239142
Provider Mailing Phone/Fax
| Phone: | 7407889220 |
| Fax: | 7405228070 |