Provider Demographics
NPI:1730971763
Name:WEST, GARY ORVILLE
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:ORVILLE
Last Name:WEST
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 1:9500 BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GLENFORD
Mailing Address - State:OH
Mailing Address - Zip Code:43739-9609
Mailing Address - Country:US
Mailing Address - Phone:740-404-1206
Mailing Address - Fax:
Practice Address - Street 1:9500 BROWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:GLENFORD
Practice Address - State:OH
Practice Address - Zip Code:43739-9609
Practice Address - Country:US
Practice Address - Phone:740-404-1206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-17
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty