Provider Demographics
NPI:1720488737
Name:MILLIRON, JONATHAN THOMAS (DPT)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:THOMAS
Last Name:MILLIRON
Suffix:
Gender:M
Credentials:DPT
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Mailing Address - Street 1:5103 CARLISTE PIKE
Mailing Address - Street 2:GILBERT PHYSICAL THERAPY AFFILIATE OF OUTPATIENT PHYSIC
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050
Mailing Address - Country:US
Mailing Address - Phone:717-591-0955
Mailing Address - Fax:717-591-0956
Practice Address - Street 1:5103 CARLISTE PIKE
Practice Address - Street 2:GILBERT PHYSICAL THERAPY AFFILIATE OF OUTPATIENT PHYSIC
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050
Practice Address - Country:US
Practice Address - Phone:717-591-0955
Practice Address - Fax:717-591-0956
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT023801225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist