Provider Demographics
NPI:1245744416
Name:STRICKLAND, JONATHAN RICHARD (PT)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:RICHARD
Last Name:STRICKLAND
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 1:110 MACTAGGART DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3226
Mailing Address - Country:US
Mailing Address - Phone:304-389-0969
Mailing Address - Fax:304-389-0969
Practice Address - Street 1:1000 ASSOCIATION DRIVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-9264
Practice Address - Country:US
Practice Address - Phone:304-347-4372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV002357225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist