Individual
JON MICHAEL PRESTON
Active
Individual
JON MICHAEL PRESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT006667
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52068657-004
BCBSGA PROVIDER NUMBER
GA
01
—
7480721
AETNA PPO POS PIN
GA
01
—
9406564
PHCS PIN
GA
Enumeration date
01/03/2007
Last updated
07/09/2007
Update your record
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