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Individual
MARK JONATHAN BADENHOP
Active
Individual
MARK JONATHAN BADENHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
13050
NC
225100000X
Physical Therapist
Primary
P15385
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447565981
—
VA
01
—
9082561
AETNA
VA
Enumeration date
08/09/2010
Last updated
08/22/2024
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