Provider Demographics
NPI:1689074056
Name:CHOI, JONATHAN (DPT)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 MANAHAN DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-5449
Mailing Address - Country:US
Mailing Address - Phone:443-668-7163
Mailing Address - Fax:
Practice Address - Street 1:12510 PROSPERITY DR
Practice Address - Street 2:SUITE 120
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1663
Practice Address - Country:US
Practice Address - Phone:301-680-7130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25105225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist