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General NPI Number Information
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NPI Number | 1679272413
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Entity Type | Individual
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Provider Name | JONATHAN ENG
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Gender | Male
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 18773 S NOGALES HWY STE 105
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-0403
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Country | US
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Telephone | 520-477-3130
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Fax | 480-885-1788
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Provider Business Mailing Address
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Address Line | 2001 BUTTERFIELD RD STE 1600
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1211
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 29326
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP021791T
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License Number State | DE
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP032875T
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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