Individual
JONATHAN M MENDICELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
280 W 40TH ST, HOLLAND, MI 49423-4664
(616) 796-3600
Mailing address
18256 SWISS DR APT 16, SPRING LAKE, MI 49456-9741
(231) 878-7161
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502006160
MI
Other
Enumeration date
04/21/2020
Last updated
04/21/2020
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