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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