MEDICARE: JONAS CELIAN

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	225200000X	Physical Therapy Assistant	2306605299	VA

General Provider Information

NPI Number	:	1851946487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONAS CELIAN

Provider Business Mailing Address
First Line	:	293 JEFFERSON DR
Second Line	:
City	:	PALMYRA
State	:	VA
Zip	:	22963-2601
Country	:	US
Telephone Number	:	954-821-6785
Fax Number	:

Provider Business Practice Location Address
First Line	:	4238 JAMES MADISON HWY
Second Line	:
City	:	FORK UNION
State	:	VA
Zip	:	23055
Country	:	US
Telephone Number	:	434-842-2916
Fax Number	:

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

Provider Enumeration Date	:	08/09/2019
Last Update Date	:	08/09/2019

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