MEDICARE: JOHNATHAN S. MCNEILL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care

General Provider Information

NPI Number	:	1265224455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHNATHAN S. MCNEILL

Provider Business Mailing Address
First Line	:	19752 STATE ROUTE 31 STE A
Second Line	:
City	:	MOUNT VICTORY
State	:	OH
Zip	:	43340-9704
Country	:	US
Telephone Number	:	614-329-0027
Fax Number	:

Provider Business Practice Location Address
First Line	:	19752 STATE ROUTE 31 STE A
Second Line	:
City	:	MOUNT VICTORY
State	:	OH
Zip	:	43340-9704
Country	:	US
Telephone Number	:	614-329-0027
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2025
Last Update Date	:	05/21/2025

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Directions to “ JOHNATHAN S. MCNEILL ” Practice Location

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