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Individual
JON POE
Active
Individual
JON POE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1128155
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84599T
BCBS
—
01
—
8T7664
BCBS
TX
Enumeration date
07/26/2006
Last updated
04/13/2015
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