Individual
JONATHAN BENNETT MCNABB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
395 STONE BLUFF LN, ALVATON, KY 42122-9721
(270) 791-5972
Mailing address
395 STONE BLUFF LN, ALVATON, KY 42122-9721
(270) 791-5972
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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