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General NPI Number Information
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NPI Number | 1023465887
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Entity Type | Individual
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Provider Name | JONATHAN HARTMAN MSAT, ATC, LAT
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Gender | Male
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Dates
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Enumeration Date | 05/20/2016
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Last Update Date | 05/20/2016
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Provider Practice Location Address
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Address Line | 4251 POWHATAN AVE
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City | NORFOLK
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State | VA
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Zip | 23508-2225
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Country | US
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Telephone | 757-683-3677
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Fax |
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Provider Business Mailing Address
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Address Line | 9549 25TH BAY ST
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City | NORFOLK
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State | VA
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Zip | 23518-1811
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Country | US
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Telephone | 603-401-7762
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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