Provider Demographics
NPI:1770334872
Name:GOZON, ESZTER (LMT)
Entity type:Individual
Prefix:
First Name:ESZTER
Middle Name:
Last Name:GOZON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3466 RIVER NARROWS RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7854
Mailing Address - Country:US
Mailing Address - Phone:614-369-0664
Mailing Address - Fax:
Practice Address - Street 1:7287 SAWMILL RD STE 100
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9609
Practice Address - Country:US
Practice Address - Phone:614-369-0664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.023283225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist