Individual
JOHNATHON CHISUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
70 MEDICAL CENTER CIR STE 103, FISHERSVILLE, VA 22939-2273
(540) 245-7400
(540) 245-7401
Mailing address
PO BOX 388, FISHERSVILLE, VA 22939-0388
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001268
VA
Other
Enumeration date
06/18/2006
Last updated
06/22/2023
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