Provider Demographics
NPI:1023465887
Name:HARTMAN, JONATHAN (MSAT, ATC, LAT)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:MSAT, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9549 25TH BAY ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-1811
Mailing Address - Country:US
Mailing Address - Phone:603-401-7762
Mailing Address - Fax:
Practice Address - Street 1:4251 POWHATAN AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-2225
Practice Address - Country:US
Practice Address - Phone:757-683-3677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer