Individual
MR. JONATHAN WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1239 CEDAR RD, CHESAPEAKE, VA 23322-7103
(757) 549-9935
Mailing address
643 COLONEL BYRD ST, CHESAPEAKE, VA 23323-1414
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110008333
VA
Other
Enumeration date
05/22/2015
Last updated
10/10/2022
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