Jonathan Gage Beaber, ATC
Specialist/Technologist, Athletic Trainer in Sylvania, OH. Individual provider (NPI-1).
NPI number1083095103
StatusActive
Last updated in NPPESMay 29, 2025
Details
- NPI
- 1083095103
- Entity type
- Individual (NPI-1)
- Name
- Jonathan Gage Beaber
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 15, 2015
- Certification date
- May 29, 2025
- Last updated
- May 29, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
7640 Sylvania Ave Ste ESylvania, OH 43560-9263
Phone 419-251-2061
Mailing address
403 Superior StGenoa, OH 43430-1733
Phone 419-307-7706
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