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General NPI Number Information
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NPI Number | 1265299200
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Entity Type | Individual
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Provider Name | JONATHAN RONO
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Gender | Male
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Dates
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Enumeration Date | 03/05/2024
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 8301 N CENTRAL EXPY
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City | DALLAS
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State | TX
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Zip | 75225-4409
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Country | US
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Telephone | 214-234-1035
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Fax |
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Provider Business Mailing Address
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Address Line | 2859 W RIVERRIDGE DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-5881
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Country | US
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Telephone | 479-440-7210
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 234847
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License Number State | TX
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