Individual
JONATHAN VADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1941 SAVAGE RD STE 300A, CHARLESTON, SC 29407-4790
(843) 402-1495
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8706
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8706
LICENSE
SC
Enumeration date
08/04/2017
Last updated
08/04/2017
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