Provider Demographics
NPI:1013918499
Name:MCGEE, JONATHON CASEY (DPT)
Entity Type:Individual
Prefix:
First Name:JONATHON
Middle Name:CASEY
Last Name:MCGEE
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 1:521 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-3460
Mailing Address - Country:US
Mailing Address - Phone:615-444-9400
Mailing Address - Fax:615-444-9406
Practice Address - Street 1:521 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3460
Practice Address - Country:US
Practice Address - Phone:615-444-9400
Practice Address - Fax:615-444-9406
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7150225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3645099Medicaid
TN3645099Medicaid