Provider Demographics
NPI:1336615830
Name:STREFLING, JONATHON (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JONATHON
Middle Name:
Last Name:STREFLING
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-2421
Mailing Address - Country:US
Mailing Address - Phone:805-202-9479
Mailing Address - Fax:
Practice Address - Street 1:618 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-2421
Practice Address - Country:US
Practice Address - Phone:805-202-9479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013525225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist