Individual
JONATHAN MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1901 TATE SPRINGS RD, LYNCHBURG, VA 24501-1109
(434) 200-3000
Mailing address
2004 WARDS FERRY RD APT 14, LYNCHBURG, VA 24502-2475
(434) 509-6939
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/08/2019
Last updated
08/08/2019
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