Individual
MR. JONATHAN L CHENNAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOT
Contact information
Practice address
1397 BROADVIEW AVE, APT 2, COLUMBUS, OH 43212-2845
(614) 512-9879
Mailing address
1397 BROADVIEW AVE, APT 2, COLUMBUS, OH 43212-2845
(614) 512-9879
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008106
OH
Other
Enumeration date
10/23/2012
Last updated
10/23/2012
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