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NPI Code Detail

MEDICARE: MR. JOHNATHAN SELLEY

MEDICARE:  MR. JOHNATHAN  SELLEY
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
1237700000XHearing Instrument Specialist3501005425MI

General Provider Information

NPI Number : 1437516051
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHNATHAN SELLEY
Provider Business Mailing Address
First Line : 2046 S CEDAR ST
Second Line :
City : IMLAY CITY
State : MI
Zip : 48444-9606
Country : US
Telephone Number : 810-721-7274
Fax Number :
Provider Business Practice Location Address
First Line : 2046 S CEDAR ST
Second Line :
City : IMLAY CITY
State : MI
Zip : 48444-9606
Country : US
Telephone Number : 810-721-7274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2016
Last Update Date : 01/27/2016

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Directions to “ MR. JOHNATHAN SELLEY ” Practice Location

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