Individual
JONATHAN BENNETT MCNABB
Active
Individual
JONATHAN BENNETT MCNABB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004115
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000310071
ANTHEM
KY
01
—
000000532436
ANTHEM
KY
01
—
7659534
AETNA
—
05
—
87001129
—
KY
01
—
P00363023
RAILROAD MEDICARE
KY
Enumeration date
06/27/2005
Last updated
05/17/2023
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