Provider Demographics
NPI:1164236220
Name:GASSMAN, JONATHAN
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:GASSMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2213 PARIS AVE SE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:OH
Mailing Address - Zip Code:44669-9730
Mailing Address - Country:US
Mailing Address - Phone:330-238-0494
Mailing Address - Fax:
Practice Address - Street 1:2213 PARIS AVE SE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:OH
Practice Address - Zip Code:44669-9730
Practice Address - Country:US
Practice Address - Phone:330-238-0494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver