Individual
JONATHAN NICOLAS BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7248 OLD MOUNTAIN RD, ROANOKE, VA 24019-5117
(814) 341-8701
Mailing address
7248 OLD MOUNTAIN RD, ROANOKE, VA 24019-5117
(814) 341-8701
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/20/2026
Last updated
01/20/2026
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