Provider Demographics
NPI:1942435912
Name:MIHELLIS, JONATHAN (PT)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:MIHELLIS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 PAR 3 DRIVE
Mailing Address - Street 2:
Mailing Address - City:FOLLANSBEE
Mailing Address - State:WV
Mailing Address - Zip Code:26037
Mailing Address - Country:US
Mailing Address - Phone:304-527-7237
Mailing Address - Fax:
Practice Address - Street 1:1562 CADIZ RD
Practice Address - Street 2:SUITE B
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953-7630
Practice Address - Country:US
Practice Address - Phone:740-264-1417
Practice Address - Fax:740-264-9395
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT002478W225100000X
PAPT013611L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist