SearchPennsylvania390200000X

Gannon Jaquay

NPI 1306767660 · on the registry since 2026 · sole proprietor

Practice

Address
5763 Route 958
Bear Lake, PA 16402
Phone
(814) 779-1115

Registry record

Primary taxonomy
390200000X
390200000X
Also registered as
2255A2300X
Sex
Male
Record last updated
2026-07-23

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Pennsylvania