Provider Demographics
NPI:1053032581
Name:STRENGHOLT, JONATHAN
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:STRENGHOLT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19687 W EXETER BLVD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-5416
Mailing Address - Country:US
Mailing Address - Phone:949-246-3791
Mailing Address - Fax:
Practice Address - Street 1:4236 N VERRADO WAY STE 203
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-7577
Practice Address - Country:US
Practice Address - Phone:623-401-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32540225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist