Individual
JONATHON ALLAN SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
46961 VAN DYKE AVE, SHELBY CHARTER TOWNSHIP, MI 48317
(586) 991-5205
Mailing address
1366 PEACHWOOD DR, FLINT, MI 48507-5635
(810) 265-9539
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601008879
MI
Other
Enumeration date
10/15/2018
Last updated
10/15/2018
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