Provider Demographics
NPI:1285191015
Name:GARRISON, JSONVIE'EV M (LMT)
Entity Type:Individual
Prefix:MRS
First Name:JSONVIE'EV
Middle Name:M
Last Name:GARRISON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:JSONVIE'EV
Other - Middle Name:M
Other - Last Name:PASCHAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7049 TAYLORSVILLE RD STE A
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-3190
Mailing Address - Country:US
Mailing Address - Phone:937-233-1755
Mailing Address - Fax:937-233-1655
Practice Address - Street 1:7049 TAYLORSVILLE RD STE A
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-3190
Practice Address - Country:US
Practice Address - Phone:937-233-1755
Practice Address - Fax:937-233-1655
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.022613225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist